title: Coronary artery bypass graft surgery using the radial artery as a secondary conduit improves patient survival.
abstract: BACKGROUND
  The clinical benefits of the left internal thoracic artery-to-left anterior descending coronary artery graft are well established in coronary artery bypass graft surgery (CABG). However, limited data are available regarding the long-term outcome of the radial artery (RA) as a secondary conduit over the established standard of the saphenous venous graft.
  
  
  RESULTS
  We compared the 12-year survival outcome in a set of propensity-matched CABG patients who received either the RA or the saphenous vein as a secondary conduit. A multivariable logistic regression that included 18 baseline characteristics was used to define the propensity of receiving an RA graft. The propensity model resulted in 260 matched pairs who underwent first-time isolated CABG from 1996 to 2001 with similar preoperative characteristics (C statistic=0.86). The cumulative 12-year survival estimated by use of the Kaplan-Meier method was higher for the RA graft patients (hazard ratio 0.76; P=0.03). This survival advantage was especially significant in diabetics (P=0.005), in women (P=0.02), and in the elderly (P=0.04.) The protective effect appeared beginning at year 5 post surgical intervention.
  
  
  CONCLUSIONS
  The RA as a secondary conduit provided superior long-term survival after CABG, especially in diabetic patients, women, and the elderly. This effect was most pronounced >5 years after surgery.
authors: Division of Cardiothoracic Surgery, Cedars Sinai Heart Institute, Los Angeles, CA.
authors: John
authors: J
authors: Lin
authors: Wen
authors: W
authors: Cheng
authors: Lawrence S
authors: LS
authors: Czer
authors: Michele A
authors: MA
authors: De Robertis
authors: James
authors: J
authors: Mirocha
authors: Andrea
authors: A
authors: Ruzza
authors: Robert M
authors: RM
authors: Kass
authors: Ali
authors: A
authors: Khoynezhad
authors: Danny
authors: D
authors: Ramzy
authors: Fardad
authors: F
authors: Esmailian
authors: Alfredo
authors: A
authors: Trento
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057216:Propensity Score; D017534:Radial Artery / Q000637:transplantation*; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation; D012737:Sex Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
keywords: coronary artery disease; radial artery graft; revascularization
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