片側対両側内胸動脈グラフト(LBCT.02)

ART：内胸動脈グラフトは片側と両側とで臨床転帰は同様である
ART: Single and bilateral artery grafting have similar clinical outcomes at five years
内胸動脈グラフトは片側と両側とで臨床転帰は同様である、と2016年American Heart Association学術集会で発表された。Arterial Revascularization Trial（ART）では、片側または両側グラフトによる冠動脈バイパス術を予定されている患者3,102人（平均年齢64歳、女性24%）を、ランダム化割り付けした。5年後、両側手術と片側手術とで臨床転帰は同様であった。片側動脈グラフト群における死亡率は8.4%であり、両側動脈グラフト群では8.7%であった。死亡、心筋梗塞および脳卒中の複合エンドポイントは、片側動脈グラフト群で12.7%であり、両側動脈グラフト群で12.2%であった。
Full Text

Single and bilateral artery grafting have similar clinical outcomes according to research reported at a Late Breaking Clinical Trial session at the American Heart Association's Scientific Sessions 2016.

There is growing evidence from observational studies that using two internal mammary arteries for grafting may be superior to single internal mammary artery grafting for coronary artery disease.

The Arterial Revascularization Trial (ART) randomized 3,102 patients (average age 64, 24 percent women) scheduled for coronary artery bypass grafting to single grafts (1554) or bilateral grafts (1448) in 28 cardiac surgical centers in seven countries.

The primary outcome was death from any cause. Secondary outcomes included the composite of death, heart attack, stroke, and additional safety outcomes. At five years follow-up, researchers noted that bilateral surgery provided similar clinical outcomes to single artery grafting. The death rate in the single artery grafting group was 8.4% compared to 8.7% in bilateral group.

As for the composite of death, heart attack and stroke was 12.7 percent for single artery grafting versus 12.2 percent for bilateral grafts.

Researchers found no statistically significant differences in the numbers of deaths, heart attack or strokes between the single and bilateral grafting after 5 years.

Follow up to ten years is ongoing to determine if bilateral grafts provides longer term benefits as single vein graft failure becomes more common after 5 years.