Evidence map›Paper›PMID 36805638›Full record

Trial reportEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2023

Anterolateral territory coronary artery bypass grafting strategies: a non-inferiority randomized clinical trial: the AMI-PONT trial.

Louis-Mathieu Stevens, Carl Chartrand-Lefebvre, Samer Mansour, Vincent Béland, Gilles Soulez, Jessica Forcillo, Fadi Basile, Ignacio Prieto, Nicolas Noiseux

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01585285 (Composite Arterial and Venous Grafting Strategy Versus Conventional Coronary Artery Bypass Grafting for the Anterolateral Territory), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01585285 nacompletednot on this map

Composite Arterial and Venous Grafting Strategy Versus Conventional Coronary Artery Bypass Grafting for the Anterolateral Territory: a Prospective Randomized Clinical Trial

TypeinterventionalSponsorCentre hospitalier de l'Université de Montréal (CHUM)Ran2012 to 2022Enrolled208ConditionsCoronary Artery DiseaseArmsLIMA to SVG Bridge Technique, Conventional CABG
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Louis-Mathieu StevensDivision of Cardiac Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.ORCID 0000-0003-3372-3419
Carl Chartrand-LefebvreCHUM Research Centre (CRCHUM), Montreal, QC, Canada.
Samer MansourCHUM Research Centre (CRCHUM), Montreal, QC, Canada.
Vincent BélandCHUM Research Centre (CRCHUM), Montreal, QC, Canada.
Gilles SoulezCHUM Research Centre (CRCHUM), Montreal, QC, Canada.
Jessica ForcilloDivision of Cardiac Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Fadi BasileDivision of Cardiac Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Ignacio PrietoDivision of Cardiac Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Nicolas NoiseuxDivision of Cardiac Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Centre Hospitalier de l’Université de Montréal · CA

Funding

CIHR
6 · The paper itself

Abstract

objectivesThe main objective was to assess whether a composite coronary artery bypass grafting strategy including a saphenous vein graft bridge to distribute left internal mammary artery outflow provides non-inferior patency rates compared to conventional grafting surgery with separated left internal mammary artery to left anterior descending coronary graft and aorto-coronary saphenous vein grafts to other anterolateral targets.

methodsAll patients underwent isolated grafting surgery with cardiopulmonary bypass and received ≥2 grafts/patients on the anterolateral territory. The graft patency (i.e. non-occluded) was assessed using multislice spiral computed tomography at 1 year.

resultsFrom 2012 to 2021, 208 patients were randomized to a bridge (n = 105) or conventional grafting strategy (n = 103). Patient characteristics were comparable between groups. The anterolateral graft patency was non-inferior in the composite bridge compared to conventional grafting strategy at 1 year [risk difference 0.7% (90% confidence interval -4.8 to 6.2%)]. The graft patency to the left anterior descending coronary was no different between groups (P = 0.175). Intraoperatively, the bridge group required shorter vein length for anterolateral targets (P < 0.001) and exhibited greater Doppler flow in the mammary artery pedicle (P = 0.004). The composite outcome of death, myocardial infarction or target vessel reintervention at 30 days was no different (P = 0.164).

conclusionsAnterolateral graft patency of the composite bridge grafting strategy is non-inferior to the conventional grafting strategy at 1 year. This novel grafting strategy is safe, efficient, associated with several advantages including better mammary artery flow and shorter vein requirement, and could be a valuable alternative to conventional grafting strategies. Ten-year clinical follow-up is underway.

trial registrationClinicalTrials.gov: NCT01585285.

Indexed as

Coronary Artery BypassAgedFemaleHumansMaleMammary ArteriesMiddle AgedSaphenous VeinTreatment OutcomeCardiopulmonary bypassCoronary artery bypass graftingMultislice computed tomography angiographyRandomized clinical non-inferiority trial

Identifiers

PMID36805638
PMCPMC10133400
OpenAlexW4321471276

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.