Coronary artery bypass graft surgery using the radial artery as a secondary conduit improves patient survival.

The clinical benefits of the left internal thoracic artery-to-left anterior descending coronary artery graft are well established in coronary artery bypass graft surgery (cabg). however,limited data are available regarding the long-term outcome of the radial artery (ra) as a secondary conduit over the established standard of the saphenous venous graft. we compared the 12-year survival outcome in a set of propensity-matched cabg patients who received either the ra or the saphenous vein as a secondary conduit. a multivariable logistic regression that included 18 baseline characteristics was used to define the propensity of receiving an ra graft. the propensity model resulted in 260 matched pairs who underwent first-time isolated cabg from 1996 to 2001 with similar preoperative characteristics (c statistic=0.86). the cumulative 12-year survival estimated by use of the kaplan-meier method was higher for the ra graft patients (hazard ratio 0.76; p=0.03). this survival advantage was especially significant in diabetics (p=0.005),in women (p=0.02),and in the elderly (p=0.04.) the protective effect appeared beginning at year 5 post surgical intervention. the ra as a secondary conduit provided superior long-term survival after cabg,especially in diabetic patients,women,and the elderly. this effect was most pronounced >5 years after surgery.