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Incidence and prognostic impact of incomplete revascularization documented by coronary angiography 1 year after coronary artery bypass grafting

The American Journal of Cardiology Jul 29, 2020

Hattler B, Grover FL, Wagner T, et al. - Given the correlation of complete revascularization (CR) at the time of coronary artery bypass graft (CABG) surgery with improved long-term cardiac outcomes, researchers here examined angiographically confirmed CR rates post-CABG. Further, they examined the impact of CR vs incomplete revascularization (IR), confirmed by coronary angiography 1 year after CABG, upon long-term outcomes. They assessed randomized On/Off Bypass Study patients who returned for protocol-specified 1-year post-CABG coronary angiograms. Among 1,276 assessed patients, CR was achieved in 756 (59%) and IR was observed in 520 (41%). Major adverse cardiovascular event (MACE; all-cause mortality, nonfatal myocardial infarction, repeat revascularization) was reported in 13% of cases with CR vs 26% of cases with IR. Findings confirm the association of CR confirmed by post-CABG angiography with improved MACE but not mortality. The potential mortality differences may have ameliorated due to repeat revascularization of patients with IR, driven by knowledge of the research angiography results.

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