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Long-term outcomes associated with total arterial revascularization vs non–total arterial revascularization

JAMA Feb 26, 2020

Rocha RV, Tam DV, Karkhanis R, et al. - In this multicenter population-based study, the long-term clinical outcomes of total arterial revascularization (TAR) vs non-TAR (CABG with at least 1 arterial and 1 saphenous vein graft) were compared. This analysis using propensity score matching took place from October 2008 to March 2017 in Ontario, Canada, with a mean and maximum follow-up of 4.6 and 9.0 years, respectively. Researchers distinguished patients with primary isolated CABG, with at least 1 arterial graft. In this study, exclusion criteria were individuals from out of province and younger than 18 years. Among 49,404 patients with primary isolated CABG, 2433 (4.9%) received TAR, with the total number of bypasses being 2, 3, and 4 or more vessels in 1521 (62.5%), 865 (35.6%), and 47 individuals (1.9%), respectively. For individuals with reasonable life expectancy requiring CABG, total arterial revascularization was correlated with enhanced long-term freedom from major adverse cardiac and cerebrovascular events, death, and myocardial infarction and may be the procedure of choice.
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