Should Coronary Artery Bypass Grafting Be Performed in Patients With Moderate Stenosis of the LAD?
In this issue of Circulation, Harskamp and colleagues use 12- to 18-month angiographic follow-up data from the PREVENT IV trial to determine the frequency of internal thoracic artery (ITA) graft failure, its risk factors, and its association with postoperative clinical events.1 They identified left anterior descending coronary artery (LAD) stenosis <75%, additional bypass graft to a diagonal, and absence of diabetes as risk factors for ITA graft failure, and reported that graft failure was associated with a high risk of postoperative repeat revascularization. Due to the association of ITA failure with moderate LAD stenosis and risk of early postoperative revascularization, the authors question the benefit of coronary artery bypass grafting (CABG) in patients with moderate, or non-ischemia-producing, lesions of the LAD.
- Received December 2, 2015.
- Accepted December 7, 2015.