One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial

TY - JOUR

T1 - One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial

AU - Damgaard, Sune

AU - Wetterslev, Jørn

AU - Lund, Jens T

AU - Lilleør, Nikolaj B

AU - Perko, Mario J

AU - Kelbaek, Henning

AU - Madsen, Jan K

AU - Steinbrüchel, Daniel A

N1 - Keywords: Aged; Coronary Angiography; Coronary Artery Bypass; Coronary Stenosis; Disease-Free Survival; Female; Graft Survival; Humans; Kaplan-Meiers Estimate; Male; Middle Aged; Treatment Outcome; Vascular Patency

PY - 2009

Y1 - 2009

N2 - AIMS: To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR). METHODS AND RESULTS: We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional revascularization (CR) using left ITA and vein grafts. The primary angiographic outcome was the patency index: number of patent grafts (<50% stenosed) divided by number of constructed grafts. One-year angiography was complete for 83% of patients. Mean patency index (+/-SD) was 87 +/- 22% in the TAR group and 88 +/- 18% in the conventional group (P = 0.52). In 72% of TAR patients and 67% of the conventional group, all grafts were patent (P = 0.45). Multiple imputation of missing angiographic data did not influence on results. Within 1 year, 37 (23%) TAR patients and 43 (25%) conventional group patients suffered cardiac events (HR 1.09, 95% CI 0.70-1.69, P = 0.70). One patient (0.6%) in the TAR group and two (1.2%) in the conventional group died (P = 1.00). CONCLUSION: Within 1 year post-operatively, TAR seems at least as safe and effective as CR. Prolonged follow-up will reveal whether this is sustained or superior results of TAR can justify a more general use.

AB - AIMS: To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR). METHODS AND RESULTS: We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional revascularization (CR) using left ITA and vein grafts. The primary angiographic outcome was the patency index: number of patent grafts (<50% stenosed) divided by number of constructed grafts. One-year angiography was complete for 83% of patients. Mean patency index (+/-SD) was 87 +/- 22% in the TAR group and 88 +/- 18% in the conventional group (P = 0.52). In 72% of TAR patients and 67% of the conventional group, all grafts were patent (P = 0.45). Multiple imputation of missing angiographic data did not influence on results. Within 1 year, 37 (23%) TAR patients and 43 (25%) conventional group patients suffered cardiac events (HR 1.09, 95% CI 0.70-1.69, P = 0.70). One patient (0.6%) in the TAR group and two (1.2%) in the conventional group died (P = 1.00). CONCLUSION: Within 1 year post-operatively, TAR seems at least as safe and effective as CR. Prolonged follow-up will reveal whether this is sustained or superior results of TAR can justify a more general use.

U2 - 10.1093/eurheartj/ehp048

DO - 10.1093/eurheartj/ehp048

M3 - Journal article

C2 - 19270315

SN - 0195-668X

VL - 30

SP - 1005

EP - 1011

JO - European Heart Journal

JF - European Heart Journal

IS - 8

ER -