What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Coronary artery disease requiring CABG (n=2091). Intervention: Arterial grafts vs. Venous grafts. Primary outcome: Long-term graft patency (RR 1.050, 95% CI 0.949 to 1.162, p=0.344).

September 16, 2019CureusOpen Access

Assessing the Long-term Patency and Clinical Outcomes of Venous and Arterial Grafts Used in Coronary Artery Bypass Grafting: A Meta-analysis

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Key result

Arterial grafts showed no significant difference in long-term patency compared to venous grafts in patients undergoing coronary artery bypass grafting (RR 1.050).

Why the study?

Choosing the second-best conduit for non-left coronary artery targets with long-term patency comparable to LITA remains controversial.

Does the use of arterial grafts compared to venous grafts improve long-term patency and clinical outcomes in patients undergoing CABG?

Comparison

Arterial grafts vs venous grafts

Design

Meta-analysis of RCTs

Authors

AWAbdül WaheedBahauddin Zakariya University EKEmily S. KlostermanEast Tennessee State University JLJoseph LeeScripps Research Institute

Discussion

Member takes

Implication

Questions arterial preference in CABG; challenges guidelines and extends equipoise for conduit choice.

Study Design

Type

Meta-Analysis (n=2,091)

Structured PICO

Does the use of arterial grafts compared to venous grafts improve long-term patency and clinical outcomes in patients undergoing CABG?

Population

2,091 patients from 8 randomized controlled trials undergoing coronary artery bypass grafting, comparing arterial versus venous grafts with long-term follow-up.

Intervention

Arterial grafts (radial artery, right internal thoracic artery, gastroduodenal artery) (n=1,164)

Comparator

Venous grafts (saphenous vein grafts) (n=927)

Outcome

Long-term patency ratehard clinical

Main Result

Relative Risk: 1.05 (95% CI 0.949–1.162)

p-value: p=0.344

This meta-analysis found no significant superiority of arterial over venous conduits regarding long-term graft patency, myocardial infarction, mortality, or revascularization following CABG.

Limitations

All included studies were small, with the largest having 529 participants
Studies did not have a fixed follow-up interval
Limited power for individual secondary outcomes

Cite This Study

Waheed et al. (2019) conducted a meta-analysis in Coronary artery disease requiring CABG (n=2,091). Arterial grafts vs. Venous grafts was evaluated on Long-term graft patency (RR 1.050, 95% CI 0.949 to 1.162, p=0.344). Arterial grafts showed no significant difference in long-term patency compared to venous grafts in patients undergoing coronary artery bypass grafting (RR 1.050).

synapsesocial.com/papers/6a8572ba02a1bc3ea31e5b1e https://doi.org/10.7759/cureus.5670

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Assessing the Long-term Patency and Clinical Outcomes of Venous and Arterial Grafts Used in Coronary Artery Bypass Grafting: A Meta-analysis

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Assessing the Long-term Patency and Clinical Outcomes of Venous and Arterial Grafts Used in Coronary Artery Bypass Grafting: A Meta-analysis

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider