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Comment & Response
July 13, 2022

Skeletonized Internal Thoracic Artery—Post Hoc Analysis vs Clinical Practice

Author Affiliations
  • 1MedStar Health Cardiac Surgery, Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
JAMA Cardiol. 2022;7(9):987-988. doi:10.1001/jamacardio.2022.1945

To the Editor We read the interesting articles by Lamy et al1 and Gaudino et al.2 Lamy et al1 conducted a post hoc analysis of the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial showing that skeletonization of the internal thoracic artery (ITA) vs pedicled technique was associated with a higher rate of graft occlusion and worse outcomes at 1 year (mainly driven by revascularization). Similar findings came from a new post hoc analysis of the Arterial Revascularization Trial by Gaudino et al2; all-cause mortality at 10 years was not different between patients with skeletonization ITA and pedicled ITA, but the rate of adverse cardiovascular events was higher in the skeletonized group.

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