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Cited by 388Cardiac and Coronary Surgery TechniquesCoronary Interventions and DiagnosticsCardiac Imaging and Diagnostics

The DOI matches its Crossref record; 45 of the 46 references it cites were found in a registry or an index.

Randomized Trial of Bilateral versus Single Internal-Thoracic-Artery Grafts

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Taggart, David P., Altman, Douglas G., Gray, Alastair M., Lees, Belinda, Gerry, Stephen, Benedetto, Umberto, Flather, Marcus·2016·New England Journal of Medicine
DOI 10.1056/nejmoa1610021
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Abstract

BACKGROUND: The use of bilateral internal thoracic (mammary) arteries for coronary-artery bypass grafting (CABG) may improve long-term outcomes as compared with the use of a single internal-thoracic-artery plus vein grafts. METHODS: We randomly assigned patients scheduled for CABG to undergo single or bilateral internal-thoracic-artery grafting in 28 cardiac surgical centers in seven countries. The primary outcome was death from any cause at 10 years. The composite of death from any cause, myocardial infarction, or stroke was a secondary outcome. Interim analyses were prespecified at 5 years of follow-up. RESULTS: A total of 3102 patients were enrolled; 1554 were randomly assigned to undergo single internal-thoracic-artery grafting (the single-graft group) and 1548 to undergo bilateral internal-thoracic-artery grafting (the bilateral-graft group). At 5 years of follow-up, the rate of death was 8.7% in the bilateral-graft group and 8.4% in the single-graft group (hazard ratio, 1.04; 95% confidence interval [CI], 0.81 to 1.32; P=0.77), and the rate of the composite of death from any cause, myocardial infarction, or stroke was 12.2% and 12.7%, respectively (hazard ratio, 0.96; 95% CI, 0.79 to 1.17; P=0.69). The rate of sternal wound complication was 3.5% in the bilateral-graft group versus 1.9% in the single-graft group (P=0.005), and the rate of sternal reconstruction was 1.9% versus 0.6% (P=0.002). CONCLUSIONS: Among patients undergoing CABG, there was no significant difference between those receiving single internal-thoracic-artery grafts and those receiving bilateral internal-thoracic-artery grafts with regard to mortality or the rates of cardiovascular events at 5 years of follow-up. There were more sternal wound complications with bilateral internal-thoracic-artery grafting than with single internal-thoracic-artery grafting. Ten-year follow-up is ongoing. (Funded by the British Heart Foundation and others; ART Current Controlled Trials number, ISRCTN46552265 .).

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  1. Glineur D, Eur J Cardiothorac Surg
  2. Weiss AJ, 2013, Ann Cardiothorac Surg, 2, 390
  3. Vallely MP, 2013, Ann Cardiothorac Surg, 2, 570

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Metadata

Authors
Taggart, D. P., Altman, D. G., Gray, A. M., Lees, B., Gerry, S., Benedetto, U., & Flather, M.
Affiliations
University of East Anglia (GB)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2016-12-29
Volume
375
Issue
26
Pages
2540-2549
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1610021
OpenAlex
W2554597692
Cited by
388
References
46
Citations by year
2026: 11 · 2025: 15 · 2024: 22 · 2023: 21 · 2022: 25 · 2021: 29 · 2020: 29 · 2019: 52 · 2018: 107 · 2017: 75 · 2016: 2
FWCI
87.09
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion, other-oa)
  • UEA Digital Repository (University of East Anglia) (acceptedVersion)
  • Northumbria Research Link (Northumbria University) (submittedVersion)
Funders
  • Cancer Research UK (16895)
  • National Institute for Health and Care Research (CDF-2015-08-074)
  • British Heart Foundation
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords
coronary artery bypass grafting, bilateral internal thoracic artery grafting, long-term mortality, myocardial infarction, stroke, sternal wound complications, sternal reconstruction, vein grafts, coronary artery disease surgery, postoperative outcomes, 10-year follow-up
MeSH terms
Aged, Coronary Artery Bypass, Cause of Death, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Male, Mammary Arteries, Middle Aged, Myocardial Infarction, Incidence, Survival Rate, Stroke

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