What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary artery disease requiring CABG (n=1074). Intervention: Internal mammary artery (IMA) grafts vs. Saphenous vein grafts (SVG). Primary outcome: Graft patency at 10 years (p=< 0.001).

What question did this study set out to answer?

To determine the 10-year patency rates and identify independent clinical predictors of long-term occlusion for saphenous vein grafts and left internal mammary artery grafts after coronary artery bypass surgery.

May 5, 2026Journal of the American College of Cardiology

Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery

Q: What are the key findings of this study?

Internal mammary artery grafts demonstrated significantly higher 10-year patency compared to saphenous vein grafts (85% vs 61%, p < 0.001) in patients undergoing coronary artery bypass grafting.

Q: What question did this study set out to answer?

To determine the 10-year patency rates and identify independent clinical predictors of long-term occlusion for saphenous vein grafts and left internal mammary artery grafts after coronary artery bypass surgery.

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Key result

Internal mammary artery grafts linked to superior 10-year patency over saphenous vein grafts, 85% vs 61%.

P<0.001
n=1,074

Why the study?

Long-term patency rates of saphenous vein grafts and internal mammary artery grafts after coronary artery bypass grafting were not well defined.

Do left internal mammary artery grafts improve long-term patency compared to saphenous vein grafts in patients undergoing CABG?

Population

1,074 patients with saphenous vein grafts and 457 patients with left internal mammary artery grafts after CABG

Comparison

Left internal mammary artery grafts vs saphenous vein grafts

Design

VA Cooperative Studies Trial cohort with serial cardiac catheterizations

Follow-up

10 years

Authors

SGSteven GoldmanHeart Failure & Transplant KZKaren ZadinaUnited States Department of Veterans Affairs TMThomas MoritzFlorida State University

Discussion

Member takes

Implication

Left internal mammary artery grafts demonstrate significantly higher 10-year patency rates compared to saphenous vein grafts in patients undergoing CABG.

Key Points

To determine the 10-year patency rates and identify independent clinical predictors of long-term occlusion for saphenous vein grafts and left internal mammary artery grafts after coronary artery bypass surgery.
Assessed 10-year saphenous vein graft patency in 1,074 patients and left internal mammary artery patency in 457 patients within a VA Cooperative Studies Trial.
Conducted protocol-mandated cardiac catheterizations at 1 week, 1 year, 3 years, 6 years, and 10 years following coronary artery bypass grafting.
Patency at 10 years was 85% for internal mammary artery grafts compared with 61% for saphenous vein grafts (p < 0.001); grafts patent at 1 week demonstrated 10-year patency rates of 88% and 68%, respectively.
Saphenous vein graft patency was 69% to the left anterior descending artery compared to 56% to the right coronary artery and 58% to the circumflex artery (p < 0.001).
Recipient vessel diameter >2.0 mm yielded an 88% saphenous vein graft patency versus 55% in vessels ≤2.0 mm (p < 0.001), with post-bypass aspirin therapy, older age, lower cholesterol, and better functional class also predicting patency (p < 0.001 to 0.058).

Study Design

Type

Cohort (n=1,074)

Multicenter

Yes

Structured PICO

Do left internal mammary artery grafts improve long-term patency compared to saphenous vein grafts in patients undergoing CABG?

Population

1,074 patients undergoing coronary artery bypass grafting followed for 10 years with serial cardiac catheterizations to assess graft patency.

Exposure

Left internal mammary artery (IMA) grafts

Comparator

Saphenous vein grafts (SVG)

Outcome

Graft patency at 10 years assessed by cardiac catheterizationsurrogate

Main Result

Absolute Event Rate: 85% vs 61%

p-value: p=< 0.001

Left internal mammary artery grafts demonstrate significantly higher 10-year patency rates compared to saphenous vein grafts in patients undergoing CABG.

Cite This Study

Goldman et al. (2004) conducted a cohort in Coronary artery disease requiring CABG (n=1,074). Internal mammary artery (IMA) grafts vs. Saphenous vein grafts (SVG) was evaluated on Graft patency at 10 years (p=< 0.001). Internal mammary artery grafts demonstrated significantly higher 10-year patency compared to saphenous vein grafts (85% vs 61%, p < 0.001) in patients undergoing coronary artery bypass grafting.

synapsesocial.com/papers/69fa5ec37d441863e550241d https://doi.org/10.1016/j.jacc.2004.08.064

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Implication

Left internal mammary artery grafts demonstrate significantly higher 10-year patency rates compared to saphenous vein grafts in patients undergoing CABG.

Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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