This preprint is under consideration at Journal of Cardiothoracic Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research article
Rui Wang
Nanjing First Hospital
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Advantages of multiple arterial conduits for coronary artery bypass graft (CABG) have been reported previously. We aimed to evaluate the mid-term outcomes of multiple arterial CABG (MABG) among patients with mild to moderate left ventricular systolic dysfunction (LVSD).
Methods: This multicenter study using propensity score matching (PSM) took place from January 2013 to June 2019 in Jiangsu Province and Shanghai, China, with a mean and maximum follow-up of 3.3 and 6.8 years, respectively. We included patients with LVSD, underwent primary, isolated multi-vessel CABG with left internal thoracic artery (LITA). The in-hospital and mid-term outcomes of MABG versus traditional LITA supplemented by saphenous vein grafts [single arterial CABG (SABG)] were compared. The primary endpoints were death from all causes and death from cardiovascular causes. The secondary endpoints were stroke, myocardial infarction (MI) and repeat revascularization, and a composite of all mentioned outcomes, including death from all causes [major adverse events (MAEs)]. Sternal wound infection was included with 6 months of follow-up after surgery.
Results: 243 and 676 patients were formed in the MABG and SABG after PSM in a 1:3 ratio. Compared with SABG, MABG was associated with lower rate of MAEs (HR, 0.64; 95% CI, 0.44-0.94; P=0.02), MI (HR, 0.39; 95% CI, 0.16-0.99; P=0.05) and repeat revascularization (HR, 0.42; 95% CI, 0.18-0.97; P=0.03). There was no difference in the rate of death, stroke, and sternal wound infection.
Conclusions: In patients with mild to moderate LVSD, MABG was associated with reduced mid-term rate of MAEs and cardiovascular events, but without reduced rate of death and stroke. MABG did not increase sternal wound infection rate.
Keywords
Radial artery; Internal thoracic artery; Coronary artery bypass graft; Left ventricular systolic dysfunction
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CURRENT STATUS: Under Review
Version 1
Posted 30 Jul, 2020
Community comments: 1
Reviewer #2 agreed
On 13 Mar, 2021
Review #2 received
Received 13 Mar, 2021
Editorial decision: Major revision
On 13 Mar, 2021
Review #1 received
Received 14 Aug, 2020
Reviewer #1 agreed
On 02 Aug, 2020
Reviewers invited
Invitations sent on 01 Aug, 2020
First submitted
On 27 Jul, 2020
Editor assigned
On 27 Jul, 2020
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On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
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This preprint is under consideration at Journal of Cardiothoracic Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Rui Wang
Nanjing First Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 30 Jul, 2020
Community comments: 1
Reviewer #2 agreed
On 13 Mar, 2021
Review #2 received
Received 13 Mar, 2021
Editorial decision: Major revision
On 13 Mar, 2021
Review #1 received
Received 14 Aug, 2020
Reviewer #1 agreed
On 02 Aug, 2020
Reviewers invited
Invitations sent on 01 Aug, 2020
First submitted
On 27 Jul, 2020
Editor assigned
On 27 Jul, 2020
Submission checks complete
On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Advantages of multiple arterial conduits for coronary artery bypass graft (CABG) have been reported previously. We aimed to evaluate the mid-term outcomes of multiple arterial CABG (MABG) among patients with mild to moderate left ventricular systolic dysfunction (LVSD).
Methods: This multicenter study using propensity score matching (PSM) took place from January 2013 to June 2019 in Jiangsu Province and Shanghai, China, with a mean and maximum follow-up of 3.3 and 6.8 years, respectively. We included patients with LVSD, underwent primary, isolated multi-vessel CABG with left internal thoracic artery (LITA). The in-hospital and mid-term outcomes of MABG versus traditional LITA supplemented by saphenous vein grafts [single arterial CABG (SABG)] were compared. The primary endpoints were death from all causes and death from cardiovascular causes. The secondary endpoints were stroke, myocardial infarction (MI) and repeat revascularization, and a composite of all mentioned outcomes, including death from all causes [major adverse events (MAEs)]. Sternal wound infection was included with 6 months of follow-up after surgery.
Results: 243 and 676 patients were formed in the MABG and SABG after PSM in a 1:3 ratio. Compared with SABG, MABG was associated with lower rate of MAEs (HR, 0.64; 95% CI, 0.44-0.94; P=0.02), MI (HR, 0.39; 95% CI, 0.16-0.99; P=0.05) and repeat revascularization (HR, 0.42; 95% CI, 0.18-0.97; P=0.03). There was no difference in the rate of death, stroke, and sternal wound infection.
Conclusions: In patients with mild to moderate LVSD, MABG was associated with reduced mid-term rate of MAEs and cardiovascular events, but without reduced rate of death and stroke. MABG did not increase sternal wound infection rate.
Figure 1
Figure 2
Figure 3
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