RITA, RA confer comparable long-term efficacies during CABG

In patients undergoing coronary artery bypass grafting (CABG), the use of either right internal thoracic artery (RITA) or radial artery (RA) as a second arterial conduit is safe and leads to comparable long-term clinical outcome, a recent study has found.

Researchers conducted a retrospective analysis of 1,198 patients. After propensity score matching, 398 balanced pairs of CABG patients who received either RITA or RA remained. In the short-term, 30-day analysis, mortality, in-hospital stroke and myocardial infarction, and reoperation outcomes were comparable between the two groups.

A similar trend was reported for long-term outcomes, assessed over a median follow-up of 7.53 years. The 5-year survival probability in the RITA and RA groups were 93.8 percent and 94.5 percent, respectively. At 10 years, the corresponding probabilities were 81.2 percent and 76.2 percent, and these further dropped to 63.2 percent and 62.5 percent at 15 years.

None of the differences were statistically significant (stratified log-rank p=0.53).

The same was true for freedom from major adverse cardiac and cerebral events, which had 5-year, 10-year, and 15-year survival probabilities of 92.0 percent vs 93.7 percent, 75.0 percent vs 73.8 percent, and 46.9 percent vs 47.2 percent in the RITA and RA groups, respectively.

“The choice of optimal second arterial conduit should be guided mainly by patients’ characteristics and surgeons’ preferences,” the researchers said.