Taggart DP, et al. - Researchers analyzed the use of bilateral internal-thoracic-artery grafts for coronary artery bypass grafting (CABG). No significant between-group difference was found in the death rate from any cause at 10 years in the intention-to-treat analysis in patients who were scheduled for CABG and had been randomly assigned to undergo bilateral or single internal-thoracic-artery grafting.

Methods

• For this investigation, patients scheduled for CABG were randomly assigned to undergo bilateral or single internal-thoracic-artery grafting.
• As indicated, additional arterial or vein grafts were used.
• Death from any cause at 10 years was the primary outcome; secondary outcome included the composite of death from any cause, myocardial infarction, or stroke.

Results

• In total, 1,548 patients were randomly allocated to undergo bilateral internal-thoracic-artery grafting (the bilateral-graft group) and 1,554 to undergo single internal-thoracic-artery grafting (the single-graft group).
• In the bilateral-graft group, only 13.9% of patients received only a single internal-thoracic-artery graft and 21.8% of patients received a radial-artery graft in the single-graft group.
• There were 315 deaths (20.3% of the patients) in the bilateral-graft group and 329 deaths (21.2%) in the single-graft group (hazard ratio, 0.96; 95% confidence interval [CI], 0.82 to 1.12; P=0.62) in the intention-to-treat analysis at 10 years.
• There were 385 patients (24.9%) with an event in the bilateral-graft group and 425 patients (27.3%) with an event in the single-graft group (hazard ratio, 0.90; 95% CI, 0.79 to 1.03) in terms of the composite outcome of death, myocardial infarction or stroke.