Frontiers in Cardiovascular Medicine (Sep 2023)
Risk factors for major adverse cardiovascular events after coronary artery bypass grafting using radial artery grafts
Abstract
BackgroundCoronary artery bypass grafting using radial artery grafts (RA-CABG) has improved long-term outcomes. However, major adverse cardiovascular events (MACE-4, including all-cause death, myocardial infarction, stroke, and repeat revascularization) after RA-CABG still occur and the predictors remain uncertain. This study aimed to detect independent risk factors of MACE-4 after RA-CABG.MethodsThis is a retrospective case-control study (NCT04935086) conducted among patients who underwent primary isolated RA-CABG between 2009 and 2019 in our center. Baseline characteristics, procedure characteristics, and medication use were compared to identify the independent predictors of MACE-4, all-cause death, and myocardial infarction (MI) with univariate and then multivariate logistic regression.ResultsA total of 370 patients were analyzed using a mean follow-up duration of 48.8 ± 41.0 months. MACE-4, all-cause death, and MI occurred in 102 (27.6%), 27 (7.3%), and 66 patients (17.8%), respectively. Multivariate analysis revealed prior MI (OR = 2.12, 95%CI 1.05–4.25, P = 0.04) and RA to the left anterior descending artery (LAD) (non-left internal mammary artery to LAD) (OR = 4.87, 95%CI 1.41–16.82, P = 0.01) as independent predictors of MACE-4 after surgery. Female (OR = 4.53, 95%CI 1.06–19.41, P = 0.04), left ventricular ejection fraction (LVEF) <40% (OR = 21.00, 95%CI 1.20–368.35, P = 0.04), and RA to LAD (OR = 8.55, 95%CI 1.35–54.10, P = 0.02) were independent predictors of all-cause death. Prior MI (OR = 3.11, 95%CI 1.40–6.94, P = 0.006) emerged as an independent predictor of MI.ConclusionOur data suggested that prior MI and RA to LAD were independent predictors of MACE-4 after RA-CABG. Being female, having an LVEF < 40% and RA to LAD indicated death. Prior MI indicated new MI.
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