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.
Iacona GM, Mangi AA. Skeletonized Internal Thoracic Artery—Post Hoc Analysis vs Clinical Practice. JAMA Cardiol. 2022;7(9):987–988. doi:10.1001/jamacardio.2022.1945
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