- Calcium-channel blocker (CCB) therapy is associated with higher patency rate and lower risk for major adverse cardiac events (MACE, death, myocardial infarction and repeat revascularisation) at 5 years in patients undergoing coronary revascularisation using radial artery (RA) grafts.
Why this matters
- Findings support the routine use of CCB after coronary artery bypass graft (CABG) surgery using the RA.
- Patient-level pooled analysis of 6 randomised controlled trials evaluated the effect of CCB on mid-term clinical and angiographic outcomes of RA grafts used for CABG (n=732, 502 on CCB; median clinical follow-up: 60 months).
- Primary outcome: composite of MACE; secondary outcome: RA graft occlusion.
- Funding: supported by the National Institute for Health Research Bristol Biomedical Research Centre.
- At month 36, 72 and 108, the cumulative incidence of MACE and RA occlusion in the CCB vs no CCB was:
- MACE: 3.7% vs 9.3%; 13.4% vs 17.6% and 16.8% vs 20.5%, respectively (log-rank P=.003).
- RA occlusion: 0.9% vs 8.6%; 9.6% vs. 21.4% and 14.3% vs 38.9%, respectively (log-rank P <.001>
- After adjustment, CCB therapy was associated with a lower risk for:
- MACE (multivariate Cox HR, 0.52; 95% CI, 0.31-0.89; P=.02)
- RA graft occlusion (multivariate Cox HR, 0.20; 95% CI, 0.08-0.49; P<.001>
- Post hoc analysis.