Evidence map›Paper›PMID 38860397›Full record

Observational studyJournal of the American Heart Association2024

Skeletonized Versus Pedicled Harvesting of the Internal Thoracic Artery and Long-Term Clinical Outcomes in Coronary Artery Bypass Surgery.

Magnus Dalén, Michael Dismorr, Natalie Glaser, Ulrik Sartipy

Abstract readObservational StudyComparative Study
In one paragraph

Observational study in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Magnus DalénDepartment of Cardiothoracic Surgery Karolinska University Hospital Stockholm Sweden.ORCID 0000-0001-5352-5132
Michael DismorrDepartment of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden.ORCID 0000-0002-5652-8774
Natalie GlaserDepartment of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden.ORCID 0000-0002-4386-1041
Ulrik SartipyDepartment of Cardiothoracic Surgery Karolinska University Hospital Stockholm Sweden.ORCID 0000-0003-2707-0263

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe internal thoracic artery (ITA) is the most important conduit for coronary artery bypass grafting. Recent evidence suggests that skeletonized ITA harvesting yields long-term outcomes inferior to those of pedicled harvesting. The aim was to investigate the impact of the ITA harvesting method on 10-year mortality and major adverse cardiovascular events. METHODS AND

resultsIn this observational cohort study, we identified all patients from the SWEDEHEART (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) register who underwent isolated coronary artery bypass grafting using at least 1 ITA at Karolinska University Hospital from 2012 to 2021. The main outcome was all-cause mortality, and the secondary outcomes were a combination of myocardial infarction, repeat revascularization, heart failure, and stroke. Outcomes were ascertained using national health data registers and compared between the skeletonized and pedicled groups using weighted flexible parametric survival models. Among 3267 patients, 1657 (51%) underwent pedicled ITA harvesting and 1610 (49%) underwent skeletonized ITA harvesting. The patients' mean age was 66 years, and 15% were women. The weighted all-cause mortality incidence rate in the pedicled versus skeletonized ITA group was 2.6% (95CI, 2.2%-3.0%) versus 2.6% (95% CI, 2.2%-3.1%), respectively (hazard ratio (HR), 1.01 [95% CI, 0.81-1.27]). The weighted major adverse cardiovascular events incidence rate was 7.8% (95% CI, 7.1%-8.6%) versus 7.5% (95% CI, 6.7%-8.4%), respectively (HR, 0.94 [95% CI, 0.82-1.08]).

conclusionsWe found no significant differences in all-cause mortality or major adverse cardiovascular events rates between the 2 ITA harvesting methods.

Indexed as

Coronary Artery BypassCoronary Artery DiseaseMammary ArteriesTissue and Organ HarvestingAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRegistriesRisk FactorsSwedenTime FactorsTreatment Outcomecardiac surgerycoronary artery bypass graftingepidemiologyinternal thoracic arterysurvival

Identifiers

PMID38860397
PMCPMC11255766

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Registered trials

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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.