Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry

Etem Caliskan; Martin Misfeld; Sigrid Sandner; Andreas Böning; Jose Aramendi; Sacha P. Salzberg; Yeong Hoon Choi; Louis P. Perrault; Ilker Tekin; Gregorio P. Cuerpo; Jose Lopez-Menendez; Luca P. Weltert; Johannes Böhm; Markus Krane; José M. González-Santos; Juan Carlos Tellez; Tomas Holubec; Enrico Ferrari; Maximilian Y. Emmert; Katharina Huenges; Herko Grubitzsch; Farhad Bakthiary; Jörg Kempfert; Adam J. Penkalla; Bernhard C. Danner; Fawad A. Jebran; Carina Benstoem; Andreas Goetzenich; Christian Stoppe; Elmar W. Kuhn; Oliver J. Liakopoulos; Stefan Brose; Klaus Matschke; Dave Veerasingam; Kishore Doddakula; Lorenzo Guerrieri Wolf; Giuseppe Filiberto Serraino; Pasquale Mastroroberto; Nicola Lamascese; Massimo Sella; Edmundo R. Fajardo-Rodriguez; Alejandro Crespo; Angel L.Fernandez Gonález; Alvaro Pedraz; Elena Arnáiz-García; Ignacio Muñoz Carvajal; Adrian J. Fontaine; José Ramón González Rodríguez; José Antonio Corrales Mera; Paloma Martinez; Jose Antonio Blazquez; Bella Ramirez; Alejandro Adsuar-Gomez; Jose M. Borrego-Dominguez; Christian Muñoz-Guijosa; Sara Badía-Gamarra; Rafael Sádaba; Alicia Gainza; Manuel Castellá; Gregorio Laguna; Javier A. Gualis; Stefanos Demertzis; Jürg Grünenfelder; Robert Bauernschmitt; Amal K. Bose; Nawwar Al-Attar; George Gradinariu

doi:10.1093/ejcts/ezac403

Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry

Etem Caliskan, Martin Misfeld, Sigrid Sandner, Andreas Böning, Jose Aramendi, Sacha P. Salzberg, Yeong Hoon Choi, Louis P. Perrault, Ilker Tekin, Gregorio P. Cuerpo, Jose Lopez-Menendez, Luca P. Weltert, Johannes Böhm, Markus Krane, José M. González-Santos, Juan Carlos Tellez, Tomas Holubec, Enrico Ferrari, Maximilian Y. Emmert, Katharina HuengesHerko Grubitzsch, Farhad Bakthiary, Jörg Kempfert, Adam J. Penkalla, Bernhard C. Danner, Fawad A. Jebran, Carina Benstoem, Andreas Goetzenich, Christian Stoppe, Elmar W. Kuhn, Oliver J. Liakopoulos, Stefan Brose, Klaus Matschke, Dave Veerasingam, Kishore Doddakula, Lorenzo Guerrieri Wolf, Giuseppe Filiberto Serraino, Pasquale Mastroroberto, Nicola Lamascese, Massimo Sella, Edmundo R. Fajardo-Rodriguez, Alejandro Crespo, Angel L.Fernandez Gonález, Alvaro Pedraz, Elena Arnáiz-García, Ignacio Muñoz Carvajal, Adrian J. Fontaine, José Ramón González Rodríguez, José Antonio Corrales Mera, Paloma Martinez, Jose Antonio Blazquez, Bella Ramirez, Alejandro Adsuar-Gomez, Jose M. Borrego-Dominguez, Christian Muñoz-Guijosa, Sara Badía-Gamarra, Rafael Sádaba, Alicia Gainza, Manuel Castellá, Gregorio Laguna, Javier A. Gualis, Stefanos Demertzis, Jürg Grünenfelder, Robert Bauernschmitt, Amal K. Bose, Nawwar Al-Attar, George Gradinariu

Clinic for Heart and Vascular Surgery

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3 Scopus citations

Abstract

OBJECTIVES: Left main coronary artery disease (LMCAD) is considered an independent risk factor for clinical events after coronary artery bypass grafting (CABG). We have conducted a subgroup analysis of the multicentre European DuraGraft Registry to investigate clinical event rates at 1 year in patients with and without LMCAD undergoing isolated CABG in contemporary practice. METHODS: Patients undergoing isolated CABG were selected. The primary end point was the incidence of a major adverse cardiac event (MACE) defined as the composite of death, myocardial infarction (MI) or repeat revascularization (RR) at 1 year. The secondary end point was major adverse cardiac and cerebrovascular events (MACCE) defined as MACE plus stroke. Propensity score matching was performed to balance for differences in baseline characteristics. RESULTS: LMCAD was present in 1033 (41.2%) and absent in 1477 (58.8%) patients. At 1 year, the MACE rate was higher for LMCAD patients (8.2% vs 5.1%, P = 0.002) driven by higher rates of death (5.4% vs 3.4%, P = 0.016), MI (3.0% vs 1.3%, P = 0.002) and numerically higher rates of RR (2.8% vs 1.8%, P = 0.13). The incidence of MACCE was 8.8% vs 6.6%, P = 0.043, with a stroke rate of 1.0% and 2.4%, P = 0.011, for the LMCAD and non-LMCAD groups, respectively. After propensity score matching, the MACE rate was 8.0% vs 5.2%, P = 0.015. The incidence of death was 5.1% vs 3.7%, P = 0.10, MI 3.0% vs 1.4%, P = 0.020, and RR was 2.7% vs 1.6%, P = 0.090, for the LMCAD and non-LMCAD groups, respectively. Less strokes occurred in LMCAD patients (1.0% vs 2.4%, P = 0.017). The MACCE rate was not different, 8.5% vs 6.7%, P = 0.12. CONCLUSIONS: In this large registry, LMCAD was demonstrated to be an independent risk factor for MACE after isolated CABG. Conversely, the risk of stroke was lower in LMCAD patients. Clinical trial registration number: ClinicalTrials.gov NCT02922088.

Original language	English
Article number	ezac403
Journal	European Journal of Cardio-thoracic Surgery
Volume	62
Issue number	4
DOIs	https://doi.org/10.1093/ejcts/ezac403
State	Published - 1 Oct 2022

Keywords

Coronary artery bypass grafting
Endothelial damage inhibitor
Left main disease
Major adverse cardiac events

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10.1093/ejcts/ezac403

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Caliskan, E., Misfeld, M., Sandner, S., Böning, A., Aramendi, J., Salzberg, S. P., Choi, Y. H., Perrault, L. P., Tekin, I., Cuerpo, G. P., Lopez-Menendez, J., Weltert, L. P., Böhm, J., Krane, M., González-Santos, J. M., Tellez, J. C., Holubec, T., Ferrari, E., Emmert, M. Y., ... Gradinariu, G. (2022). Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry. European Journal of Cardio-thoracic Surgery, 62(4), Article ezac403. https://doi.org/10.1093/ejcts/ezac403

@article{09ec56bf30a84d40b5f811ea867747c6,

title = "Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry",

abstract = "OBJECTIVES: Left main coronary artery disease (LMCAD) is considered an independent risk factor for clinical events after coronary artery bypass grafting (CABG). We have conducted a subgroup analysis of the multicentre European DuraGraft Registry to investigate clinical event rates at 1 year in patients with and without LMCAD undergoing isolated CABG in contemporary practice. METHODS: Patients undergoing isolated CABG were selected. The primary end point was the incidence of a major adverse cardiac event (MACE) defined as the composite of death, myocardial infarction (MI) or repeat revascularization (RR) at 1 year. The secondary end point was major adverse cardiac and cerebrovascular events (MACCE) defined as MACE plus stroke. Propensity score matching was performed to balance for differences in baseline characteristics. RESULTS: LMCAD was present in 1033 (41.2%) and absent in 1477 (58.8%) patients. At 1 year, the MACE rate was higher for LMCAD patients (8.2% vs 5.1%, P = 0.002) driven by higher rates of death (5.4% vs 3.4%, P = 0.016), MI (3.0% vs 1.3%, P = 0.002) and numerically higher rates of RR (2.8% vs 1.8%, P = 0.13). The incidence of MACCE was 8.8% vs 6.6%, P = 0.043, with a stroke rate of 1.0% and 2.4%, P = 0.011, for the LMCAD and non-LMCAD groups, respectively. After propensity score matching, the MACE rate was 8.0% vs 5.2%, P = 0.015. The incidence of death was 5.1% vs 3.7%, P = 0.10, MI 3.0% vs 1.4%, P = 0.020, and RR was 2.7% vs 1.6%, P = 0.090, for the LMCAD and non-LMCAD groups, respectively. Less strokes occurred in LMCAD patients (1.0% vs 2.4%, P = 0.017). The MACCE rate was not different, 8.5% vs 6.7%, P = 0.12. CONCLUSIONS: In this large registry, LMCAD was demonstrated to be an independent risk factor for MACE after isolated CABG. Conversely, the risk of stroke was lower in LMCAD patients. Clinical trial registration number: ClinicalTrials.gov NCT02922088.",

keywords = "Coronary artery bypass grafting, Endothelial damage inhibitor, Left main disease, Major adverse cardiac events",

author = "Etem Caliskan and Martin Misfeld and Sigrid Sandner and Andreas B{\"o}ning and Jose Aramendi and Salzberg, {Sacha P.} and Choi, {Yeong Hoon} and Perrault, {Louis P.} and Ilker Tekin and Cuerpo, {Gregorio P.} and Jose Lopez-Menendez and Weltert, {Luca P.} and Johannes B{\"o}hm and Markus Krane and Gonz{\'a}lez-Santos, {Jos{\'e} M.} and Tellez, {Juan Carlos} and Tomas Holubec and Enrico Ferrari and Emmert, {Maximilian Y.} and Katharina Huenges and Herko Grubitzsch and Farhad Bakthiary and J{\"o}rg Kempfert and Penkalla, {Adam J.} and Danner, {Bernhard C.} and Jebran, {Fawad A.} and Carina Benstoem and Andreas Goetzenich and Christian Stoppe and Kuhn, {Elmar W.} and Liakopoulos, {Oliver J.} and Stefan Brose and Klaus Matschke and Dave Veerasingam and Kishore Doddakula and Wolf, {Lorenzo Guerrieri} and Serraino, {Giuseppe Filiberto} and Pasquale Mastroroberto and Nicola Lamascese and Massimo Sella and Fajardo-Rodriguez, {Edmundo R.} and Alejandro Crespo and Gon{\'a}lez, {Angel L.Fernandez} and Alvaro Pedraz and Elena Arn{\'a}iz-Garc{\'i}a and Carvajal, {Ignacio Mu{\~n}oz} and Fontaine, {Adrian J.} and Rodr{\'i}guez, {Jos{\'e} Ram{\'o}n Gonz{\'a}lez} and Mera, {Jos{\'e} Antonio Corrales} and Paloma Martinez and Blazquez, {Jose Antonio} and Bella Ramirez and Alejandro Adsuar-Gomez and Borrego-Dominguez, {Jose M.} and Christian Mu{\~n}oz-Guijosa and Sara Bad{\'i}a-Gamarra and Rafael S{\'a}daba and Alicia Gainza and Manuel Castell{\'a} and Gregorio Laguna and Gualis, {Javier A.} and Stefanos Demertzis and J{\"u}rg Gr{\"u}nenfelder and Robert Bauernschmitt and Bose, {Amal K.} and Nawwar Al-Attar and George Gradinariu",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s).",

year = "2022",

month = oct,

day = "1",

doi = "10.1093/ejcts/ezac403",

language = "English",

volume = "62",

journal = "European Journal of Cardio-thoracic Surgery",

issn = "1010-7940",

publisher = "European Association for Cardio-Thoracic Surgery",

number = "4",

}

Caliskan, E, Misfeld, M, Sandner, S, Böning, A, Aramendi, J, Salzberg, SP, Choi, YH, Perrault, LP, Tekin, I, Cuerpo, GP, Lopez-Menendez, J, Weltert, LP, Böhm, J, Krane, M, González-Santos, JM, Tellez, JC, Holubec, T, Ferrari, E, Emmert, MY, Huenges, K, Grubitzsch, H, Bakthiary, F, Kempfert, J, Penkalla, AJ, Danner, BC, Jebran, FA, Benstoem, C, Goetzenich, A, Stoppe, C, Kuhn, EW, Liakopoulos, OJ, Brose, S, Matschke, K, Veerasingam, D, Doddakula, K, Wolf, LG, Serraino, GF, Mastroroberto, P, Lamascese, N, Sella, M, Fajardo-Rodriguez, ER, Crespo, A, Gonález, ALF, Pedraz, A, Arnáiz-García, E, Carvajal, IM, Fontaine, AJ, Rodríguez, JRG, Mera, JAC, Martinez, P, Blazquez, JA, Ramirez, B, Adsuar-Gomez, A, Borrego-Dominguez, JM, Muñoz-Guijosa, C, Badía-Gamarra, S, Sádaba, R, Gainza, A, Castellá, M, Laguna, G, Gualis, JA, Demertzis, S, Grünenfelder, J, Bauernschmitt, R, Bose, AK, Al-Attar, N & Gradinariu, G 2022, 'Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry', European Journal of Cardio-thoracic Surgery, vol. 62, no. 4, ezac403. https://doi.org/10.1093/ejcts/ezac403

Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry. / Caliskan, Etem; Misfeld, Martin; Sandner, Sigrid et al.
In: European Journal of Cardio-thoracic Surgery, Vol. 62, No. 4, ezac403, 01.10.2022.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting

T2 - results from the European DuraGraft Registry

AU - Caliskan, Etem

AU - Misfeld, Martin

AU - Sandner, Sigrid

AU - Böning, Andreas

AU - Aramendi, Jose

AU - Salzberg, Sacha P.

AU - Choi, Yeong Hoon

AU - Perrault, Louis P.

AU - Tekin, Ilker

AU - Cuerpo, Gregorio P.

AU - Lopez-Menendez, Jose

AU - Weltert, Luca P.

AU - Böhm, Johannes

AU - Krane, Markus

AU - González-Santos, José M.

AU - Tellez, Juan Carlos

AU - Holubec, Tomas

AU - Ferrari, Enrico

AU - Emmert, Maximilian Y.

AU - Huenges, Katharina

AU - Grubitzsch, Herko

AU - Bakthiary, Farhad

AU - Kempfert, Jörg

AU - Penkalla, Adam J.

AU - Danner, Bernhard C.

AU - Jebran, Fawad A.

AU - Benstoem, Carina

AU - Goetzenich, Andreas

AU - Stoppe, Christian

AU - Kuhn, Elmar W.

AU - Liakopoulos, Oliver J.

AU - Brose, Stefan

AU - Matschke, Klaus

AU - Veerasingam, Dave

AU - Doddakula, Kishore

AU - Wolf, Lorenzo Guerrieri

AU - Serraino, Giuseppe Filiberto

AU - Mastroroberto, Pasquale

AU - Lamascese, Nicola

AU - Sella, Massimo

AU - Fajardo-Rodriguez, Edmundo R.

AU - Crespo, Alejandro

AU - Gonález, Angel L.Fernandez

AU - Pedraz, Alvaro

AU - Arnáiz-García, Elena

AU - Carvajal, Ignacio Muñoz

AU - Fontaine, Adrian J.

AU - Rodríguez, José Ramón González

AU - Mera, José Antonio Corrales

AU - Martinez, Paloma

AU - Blazquez, Jose Antonio

AU - Ramirez, Bella

AU - Adsuar-Gomez, Alejandro

AU - Borrego-Dominguez, Jose M.

AU - Muñoz-Guijosa, Christian

AU - Badía-Gamarra, Sara

AU - Sádaba, Rafael

AU - Gainza, Alicia

AU - Castellá, Manuel

AU - Laguna, Gregorio

AU - Gualis, Javier A.

AU - Demertzis, Stefanos

AU - Grünenfelder, Jürg

AU - Bauernschmitt, Robert

AU - Bose, Amal K.

AU - Al-Attar, Nawwar

AU - Gradinariu, George

PY - 2022/10/1

Y1 - 2022/10/1

N2 - OBJECTIVES: Left main coronary artery disease (LMCAD) is considered an independent risk factor for clinical events after coronary artery bypass grafting (CABG). We have conducted a subgroup analysis of the multicentre European DuraGraft Registry to investigate clinical event rates at 1 year in patients with and without LMCAD undergoing isolated CABG in contemporary practice. METHODS: Patients undergoing isolated CABG were selected. The primary end point was the incidence of a major adverse cardiac event (MACE) defined as the composite of death, myocardial infarction (MI) or repeat revascularization (RR) at 1 year. The secondary end point was major adverse cardiac and cerebrovascular events (MACCE) defined as MACE plus stroke. Propensity score matching was performed to balance for differences in baseline characteristics. RESULTS: LMCAD was present in 1033 (41.2%) and absent in 1477 (58.8%) patients. At 1 year, the MACE rate was higher for LMCAD patients (8.2% vs 5.1%, P = 0.002) driven by higher rates of death (5.4% vs 3.4%, P = 0.016), MI (3.0% vs 1.3%, P = 0.002) and numerically higher rates of RR (2.8% vs 1.8%, P = 0.13). The incidence of MACCE was 8.8% vs 6.6%, P = 0.043, with a stroke rate of 1.0% and 2.4%, P = 0.011, for the LMCAD and non-LMCAD groups, respectively. After propensity score matching, the MACE rate was 8.0% vs 5.2%, P = 0.015. The incidence of death was 5.1% vs 3.7%, P = 0.10, MI 3.0% vs 1.4%, P = 0.020, and RR was 2.7% vs 1.6%, P = 0.090, for the LMCAD and non-LMCAD groups, respectively. Less strokes occurred in LMCAD patients (1.0% vs 2.4%, P = 0.017). The MACCE rate was not different, 8.5% vs 6.7%, P = 0.12. CONCLUSIONS: In this large registry, LMCAD was demonstrated to be an independent risk factor for MACE after isolated CABG. Conversely, the risk of stroke was lower in LMCAD patients. Clinical trial registration number: ClinicalTrials.gov NCT02922088.

AB - OBJECTIVES: Left main coronary artery disease (LMCAD) is considered an independent risk factor for clinical events after coronary artery bypass grafting (CABG). We have conducted a subgroup analysis of the multicentre European DuraGraft Registry to investigate clinical event rates at 1 year in patients with and without LMCAD undergoing isolated CABG in contemporary practice. METHODS: Patients undergoing isolated CABG were selected. The primary end point was the incidence of a major adverse cardiac event (MACE) defined as the composite of death, myocardial infarction (MI) or repeat revascularization (RR) at 1 year. The secondary end point was major adverse cardiac and cerebrovascular events (MACCE) defined as MACE plus stroke. Propensity score matching was performed to balance for differences in baseline characteristics. RESULTS: LMCAD was present in 1033 (41.2%) and absent in 1477 (58.8%) patients. At 1 year, the MACE rate was higher for LMCAD patients (8.2% vs 5.1%, P = 0.002) driven by higher rates of death (5.4% vs 3.4%, P = 0.016), MI (3.0% vs 1.3%, P = 0.002) and numerically higher rates of RR (2.8% vs 1.8%, P = 0.13). The incidence of MACCE was 8.8% vs 6.6%, P = 0.043, with a stroke rate of 1.0% and 2.4%, P = 0.011, for the LMCAD and non-LMCAD groups, respectively. After propensity score matching, the MACE rate was 8.0% vs 5.2%, P = 0.015. The incidence of death was 5.1% vs 3.7%, P = 0.10, MI 3.0% vs 1.4%, P = 0.020, and RR was 2.7% vs 1.6%, P = 0.090, for the LMCAD and non-LMCAD groups, respectively. Less strokes occurred in LMCAD patients (1.0% vs 2.4%, P = 0.017). The MACCE rate was not different, 8.5% vs 6.7%, P = 0.12. CONCLUSIONS: In this large registry, LMCAD was demonstrated to be an independent risk factor for MACE after isolated CABG. Conversely, the risk of stroke was lower in LMCAD patients. Clinical trial registration number: ClinicalTrials.gov NCT02922088.

KW - Coronary artery bypass grafting

KW - Endothelial damage inhibitor

KW - Left main disease

KW - Major adverse cardiac events

UR - http://www.scopus.com/inward/record.url?scp=85139374562&partnerID=8YFLogxK

U2 - 10.1093/ejcts/ezac403

DO - 10.1093/ejcts/ezac403

M3 - Article

C2 - 35929787

AN - SCOPUS:85139374562

SN - 1010-7940

VL - 62

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

IS - 4

M1 - ezac403

ER -

Clinical event rate in patients with and without left main disease undergoing isolated coronary artery bypass grafting: results from the European DuraGraft Registry

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