Multiple arterial CABG in diabetes patients tied to lower mortality at 10 years: Data from ART trial

Published On 2022-07-01 14:00 GMT   |   Update On 2022-07-01 14:00 GMT

UK: Multiple arterial grafting (MAG) after coronary artery bypass grafting (CABG) in diabetes patients is associated with lower mortality and MACE at 10 years versus a single arterial grafting (SAG) approach, according to findings from post hoc analysis of the Arterial Revascularization Trial (ART). The study was published in the European Heart Journal on 14 June 2022. David P....

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UK: Multiple arterial grafting (MAG) after coronary artery bypass grafting (CABG) in diabetes patients is associated with lower mortality and MACE at 10 years versus a single arterial grafting (SAG) approach, according to findings from post hoc analysis of the Arterial Revascularization Trial (ART). The study was published in the European Heart Journal on 14 June 2022. 

David P. Taggart, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK, and set out to evaluate the impact of MAG versus SAG in a post hoc analysis of 10-year outcomes in patients with diabetes mellitus (DM) from the Arterial Revascularization Trial. 

Patients were stratified by diabetes status (non-DM and DM) and grafting strategy (MAG vs. SAG). The analysis included a total of 3020 patients. ; 716 (23.7%) had DM. All-cause mortality was the primary endpoint and the secondary endpoint was a composite of major adverse cardiac events (MACE) at a 10-year follow-up. 

Based on the study, the authors revealed the following findings:

  • 55.8% of non-DM patients received MAG and 44.2% received SAG, while 56.6% of DM patients received MAG and 43.4% received SAG.
  • The use of MAG compared with SAG was associated with lower 10-year mortality for both non-DM [17.7 vs. 21.0%] and DM patients (21.5 vs. 29.9%).
  • For both groups, the rate of 10-year MACE was also lower for MAG vs. SAG.
  • Deep sternal wound infections (DSWIs) were uncommon but more frequent in the MAG vs. SAG group in both non-DM (3.3 vs. 2.1%) and DM patients (7.9 vs. 4.8%).
  • The highest rates of DSWI were in insulin-treated patients receiving MAG (9.6 vs. 6.3%, when compared with SAG).

The researchers conclude that "multiple arterial grafting leads to lower mortality at 10 years after CABG in patients with diabetes compared with a single arterial grafting approach. A higher incidence of deep sternal wound infections was seen in diabetes patients receiving DM, especially if insulin-dependent."

Reference:

David P. Taggart, Katia Audisio, Stephen Gerry, N. Bryce Robinson, Mohamed Rahouma, Giovanni Jr. Soletti, Gianmarco Cancelli, Umberto Benedetto, Belinda Lees, Alastair Gray, Maria Stefil, Marcus Flather, Mario Gaudino, ART Investigators, Single versus multiple arterial grafting in diabetic patients at 10 years: the Arterial Revascularization Trial, European Heart Journal, 2022;, ehac199, https://doi.org/10.1093/eurheartj/ehac199

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Article Source : European Heart Journal

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