Benefits of Long-Term Physical Training in Patients After Coronary Artery Bypass Grafting???A 58-Month Follow-up and Comparison With a Nontrained Group

Abstract Background The advantages of the employment of double internal thoracic artery grafts (BITA) for coronary artery bypass grafting have been recently questioned and no data on long-term follow-up are available. This observational retrospective cohort study was designed by the PRIORITY planning committee to evaluate 10-year follow-up of isolated CABG performed with and without BITA in order to clarify and consolidate the contrasting literature. Methods The PRIORITY project was designed to evaluate the long-term outcomes of 2 large prospective multicenter cohort studies on CABG conducted between 2002–2004 and 2007–2008. Data on isolated CABG were linked to 2 administrative datasets. Time-to-event distributions were separately analyzed accordingly to primary event-type (death, MACEs), using Kaplan-Meier estimates and Cox regression. Results The population consisted of 11021 patients who underwent isolated CABG that were divided into development and validation datasets; double thoracic internal artery grafts was employed in 24.6%. The median follow-up time was 8 years (interquartile range 7.6–10 years) and was 100% complete. After adjustment for potential confounding factors, BITA was significantly associated with better survival (HR 0.85, 95% CI 0.76–0.95, p=0.003). Moreover, the employment of BITA reduced the incidence of MACEs at follow-up (adjusted HR 0.87, 95% CI 0.80–0.94, p=0.001). In details, BITA was demonstrated to be a protective factor for acute myocardial infarction (adjusted HR 0.84, 95% CI 0.71–0.99, p=0.05) and for rehospitalization for percutaneous cardiac intervention (PCI; adjusted HR 0.82, 95% CI 0.70–0.96, p=0.013). Conclusions The employment of double internal thoracic artery grafts for coronary artery bypass grafting has been associated to survival advantage at 10-year. Moreover, it significantly decreased the incidence of acute myocardial infarction and rehospitalization for percutaneous cardiac intervention. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Italian Minister of Health

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O11-01 Long-term survival and prognostic implications of 2130 patients after coronary artery bypass grafting-seven-year follow up

International Journal of Cardiology ◽

10.1016/s0167-5273(04)80123-2 ◽

2004 ◽

Vol 97 ◽

pp. S37-S38

Author(s):

Ming C. Hsiung ◽

Jeng Wei ◽

Chang-Yi Chang ◽

Yi-Chang Chuang ◽

Kuo-Chen Lee ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Term Survival ◽

Artery Bypass Grafting ◽

Prognostic Implications

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Abstract 16420: Double Internal Thoracic Artery Grafts are Associated to Better 10-year Outcomes After Coronary Artery Bypass Grafting

Circulation ◽

10.1161/circ.142.suppl_3.16420 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Fabio Barili ◽

Paola DErrigo ◽

Stefano Rosato ◽

Mariangela D'Ovidio ◽

Fausto Biancari ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Protective Factor ◽

Internal Thoracic Artery ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting

Introduction: Few data on long-term follow-up of effectiveness and advantages related to the employ of double internal thoracic artery grafts (BITA) for coronary artery bypass grafting are available and the advantage of the employ of BITA have been recently questioned. Hypothesis: This observational cohort study was designed by the PRIORITY planning committee to evaluate 10-year follow-up of isolated CABG performed with and without BITA in order to evaluate the impact of BITA on long-term outcomes. Methods: The PRIORITY project was designed to evaluate the long-term outcomes of 2 large prospective multicenter cohort studies on CABG conducted between 2002-2004 and 2007-2008. Data on isolated CABG were linked to 2 administrative datasets. The primary endpoints were death and major adverse cardiac events (MACEs) at follow-up. Time-to-event data were analyzed using Kaplan-Meier estimates and Cox regression. Models generation was performed on the full dataset and the validation was performed with Montecarlo simulations. Results: The population consisted of 11021 patients who underwent isolated CABG; double thoracic internal artery grafts was employed in 23.5%. The median follow-up time was 7.9 years (interquartile range 7.4 - 10 years). After adjustment for potential confounding factors, BITA was significantly associated with better survival (HR 0.81, 95%CI 0.73-0.89, p < 0.001). Moreover, the employment of BITA reduced the incidence of MACEs at follow-up (adjusted HR 0.83, 95%CI 0.77-0.89, p < 0.001). In details, BITA was demonstrated to be a protective factor for acute myocardial infarction (adjusted HR 0.83, 95%CI 0.72-0.96, p = 0.001) and for rehospitalization for percutaneous cardiac intervention (PCI; adjusted HR 0.72, 95%CI 0.63-0.84, p < 0.001). Conclusions: The employment of double internal thoracic artery grafts for coronary artery bypass grafting has been associated to significant survival advantage at long-term. Moreover, it is a protective factor for acute myocardial infarction and rehospitalization for percutaneous cardiac intervention, reducing the hazard by 28%.

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Effects of Coronary Artery Bypass Grafting on Ventricular Arrhythmias: Results with Electrophysiological Testing and Long-Term Follow-Up

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.1993.tb04572.x ◽

1993 ◽

Vol 16 (5) ◽

pp. 984-991 ◽

Cited By ~ 32

Author(s):

ANTONIS S. MANOLIS ◽

HASSAN RASTEGAR ◽

N.A. MARK ESTES

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Ventricular Arrhythmias ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Long Term Follow Up

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Long-term Follow-up After Coronary Artery Bypass Grafting Reoperation

CHEST Journal ◽

10.1378/chest.115.6.1593 ◽

1999 ◽

Vol 115 (6) ◽

pp. 1593-1597 ◽

Cited By ~ 19

Author(s):

Itzhak Shapira ◽

Aharon Isakov ◽

Israel Heller ◽

Marcel Topilsky ◽

Amos Pines

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Long Term Follow Up

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The Impact of Cerebral Atherosclerosis According to Location on Prognosis after Coronary Artery Bypass Grafting

Cerebrovascular Diseases ◽

10.1159/000494502 ◽

2018 ◽

Vol 46 (5-6) ◽

pp. 200-209 ◽

Cited By ~ 2

Author(s):

Eun-Jae Lee ◽

Cheol-Hyun Chung ◽

Kyoung-Hyo Choi ◽

Jae-Won Lee ◽

Suk-Jung Choo ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Prognostic Value ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Cerebral Atherosclerosis

Background: In the previous prospective observational study, we found that cerebral atherosclerosis is an independent predictor of acute stroke after coronary artery bypass grafting (CABG). However, it is unknown whether intracranial cerebral atherosclerosis (ICAS) is important as much as extracranial cerebral atherosclerosis (ECAS) in estimating the risk of post-CABG adverse events. Extending the previous study, we aimed to investigate the immediate and long-term prognostic value of the location of cerebral atherosclerosis in CABG patients. Methods: This follow-up study of previously reported prospective cohort included 1,367 consecutive patients who received CABG between 2004 and 2007. All patients underwent preoperative magnetic resonance angiography (MRA) to assess intracranial and ECAS, both defined by significant steno-occlusion (≥50%). Participants were classified into 4 groups according to the location of cerebral atherosclerosis: no cerebral atherosclerosis, ECAS only, ICAS only, and ECAS + ICAS. Post-CABG stroke within 14 days (immediate outcome) and mortality (long-term outcome) following CABG were compared between the groups. Survival data for all participants through June 2016 were obtained from the Korean National Registry of Vital Statistics. The Cox proportional hazards model was used to estimate the hazard ratio (HR) of post-CABG stroke and mortality; patients lacking cerebral atherosclerosis were defined as the reference group. Results: The median follow-up duration after CABG was 9.2 years (interquartile range 8.4–10.2 years). Of the participants, 278 (20.3%) patients had ICAS only, while 269 (19.7%) and 347 (25.4%) showed ECAS only and ECAS + ICAS, respectively, in their preoperative MRA. Having ICAS only (HR 5.07; 95% CI 1.37–18.75; p = 0.015) and having ECAS + ICAS (HR 8.43; 95% CI, 2.48–28.61; p = 0.001) independently predicted the immediate stroke, whereas being with ECAS only did not (HR 1.71; 95% CI 0.35–8.50; p = 0.509). Conversely, ICAS-only status was not independently associated with long-term mortality (HR 1.22; 95% CI 0.90–1.65; p = 0.207), whereas ECAS-only status (HR 1.42; 95% CI 1.05–1.90; p = 0.021) and ECAS + ICAS status (HR 1.58; 95% CI 1.20–2.07; p = 0.001) showed independent associations. Conclusions: Over 10 years of follow-up, cerebral atherosclerosis significantly associated with the development of adverse outcomes after CABG. The prognostic value of ICAS might be different from that of ECAS; immediate post-CABG stroke was more closely associated with ICAS, whereas there was a closer association between long-term post-CABG mortality and ECAS.

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