Cited 427 times in
Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery
DC Field | Value | Language |
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dc.contributor.author | 유경종 | - |
dc.date.accessioned | 2018-08-28T17:21:58Z | - |
dc.date.available | 2018-08-28T17:21:58Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 0028-4793 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/162524 | - |
dc.description.abstract | BACKGROUND: The use of radial-artery grafts for coronary-artery bypass grafting (CABG) may result in better postoperative outcomes than the use of saphenous-vein grafts. However, randomized, controlled trials comparing radial-artery grafts and saphenous-vein grafts have been individually underpowered to detect differences in clinical outcomes. We performed a patient-level combined analysis of randomized, controlled trials to compare radial-artery grafts and saphenous-vein grafts for CABG. METHODS: Six trials were identified. The primary outcome was a composite of death, myocardial infarction, or repeat revascularization. The secondary outcome was graft patency on follow-up angiography. Mixed-effects Cox regression models were used to estimate the treatment effect on the outcomes. RESULTS: A total of 1036 patients were included in the analysis (534 patients with radial-artery grafts and 502 patients with saphenous-vein grafts). After a mean (+/-SD) follow-up time of 60+/-30 months, the incidence of adverse cardiac events was significantly lower in association with radial-artery grafts than with saphenous-vein grafts (hazard ratio, 0.67; 95% confidence interval [CI], 0.49 to 0.90; P=0.01). At follow-up angiography (mean follow-up, 50+/-30 months), the use of radial-artery grafts was also associated with a significantly lower risk of occlusion (hazard ratio, 0.44; 95% CI, 0.28 to 0.70; P<0.001). As compared with the use of saphenous-vein grafts, the use of radial-artery grafts was associated with a nominally lower incidence of myocardial infarction (hazard ratio, 0.72; 95% CI, 0.53 to 0.99; P=0.04) and a lower incidence of repeat revascularization (hazard ratio, 0.50; 95% CI, 0.40 to 0.63; P<0.001) but not a lower incidence of death from any cause (hazard ratio, 0.90; 95% CI, 0.59 to 1.41; P=0.68). CONCLUSIONS: As compared with the use of saphenous-vein grafts, the use of radial-artery grafts for CABG resulted in a lower rate of adverse cardiac events and a higher rate of patency at 5 years of follow-up. (Funded by Weill Cornell Medicine and others.). | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Massachusetts Medical Society | - |
dc.relation.isPartOf | NEW ENGLAND JOURNAL OF MEDICINE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Coronary Angiography | - |
dc.subject.MESH | Coronary Artery Bypass/adverse effects/*methods | - |
dc.subject.MESH | Coronary Artery Disease/mortality/*surgery | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Myocardial Infarction/epidemiology | - |
dc.subject.MESH | Postoperative Complications/epidemiology | - |
dc.subject.MESH | Proportional Hazards Models | - |
dc.subject.MESH | Radial Artery/*transplantation | - |
dc.subject.MESH | Randomized Controlled Trials as Topic | - |
dc.subject.MESH | Reoperation/statistics & numerical data | - |
dc.subject.MESH | Saphenous Vein/*transplantation | - |
dc.subject.MESH | Treatment Failure | - |
dc.subject.MESH | *Vascular Patency | - |
dc.title | Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Thoracic & Cardiovascular Surgery | - |
dc.contributor.googleauthor | Mario Gaudino | - |
dc.contributor.googleauthor | Umberto Benedetto | - |
dc.contributor.googleauthor | Stephen Fremes | - |
dc.contributor.googleauthor | Giuseppe Biondi-Zoccai | - |
dc.contributor.googleauthor | Art Sedrakyan | - |
dc.contributor.googleauthor | John D Puskas | - |
dc.contributor.googleauthor | Gianni D Angelini | - |
dc.contributor.googleauthor | Brian Buxton | - |
dc.contributor.googleauthor | Giacomo Frati | - |
dc.contributor.googleauthor | David L Hare | - |
dc.contributor.googleauthor | Philip Hayward | - |
dc.contributor.googleauthor | Giuseppe Nasso | - |
dc.contributor.googleauthor | Neil Moat | - |
dc.contributor.googleauthor | Miodrag Peric | - |
dc.contributor.googleauthor | Kyung J Yoo | - |
dc.contributor.googleauthor | Giuseppe Speziale | - |
dc.contributor.googleauthor | Leonard N Girardi | - |
dc.contributor.googleauthor | David P Taggart | - |
dc.identifier.doi | 10.1056/NEJMoa1716026 | - |
dc.contributor.localId | A02453 | - |
dc.relation.journalcode | J02371 | - |
dc.identifier.eissn | 1533-4406 | - |
dc.identifier.pmid | 29708851 | - |
dc.identifier.url | https://www.nejm.org/doi/10.1056/NEJMoa1716026 | - |
dc.contributor.alternativeName | Yoo, Kyung Jong | - |
dc.contributor.affiliatedAuthor | Yoo, Kyung Jong | - |
dc.citation.volume | 378 | - |
dc.citation.number | 22 | - |
dc.citation.startPage | 2069 | - |
dc.citation.endPage | 2077 | - |
dc.identifier.bibliographicCitation | NEW ENGLAND JOURNAL OF MEDICINE, Vol.378(22) : 2069-2077, 2018 | - |
dc.identifier.rimsid | 60104 | - |
dc.type.rims | ART | - |
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