Statin Treatment Equalizes Long-Term Survival Between Patients With Single and Bilateral Internal Thoracic Artery Grafts

Background. The use of 2 internal thoracic artery ( ITA) grafts increases survival 10 years after coronary artery bypass grafting (CABG) compared with single ITA grafting. Statin treatment was also shown to decrease development and progression of saphenous vein graft atherosclerosis. This study examined the effect of statin treatment on long-term survival after CABG. Methods. Operative, survival, and pharmacologic data of 6655 patients who underwent CABG with ITAs between 1995 and 2007 in our institution were obtained. Results. Patients with bilateral ITA grafts had an average 10-year-survival rate of 83% +/- 2% compared with 67% +/- 1% in patients with single ITA grafts (p = 0.0001). Statin treatment caused a significant decrease in the long-term risk of death among patients who underwent single ITA grafting ( hazard ratio [HR], 0.735, p = 0.0001). However, statin treatment had no effect on the risk of long-term death among patients who underwent bilateral ITA grafting ( HR, 1.053; p = 0.7806). Conclusions. Statin treatment initiated early after grafting improved long-term survival in patients with a single ITA graft but not in those with bilateral ITA grafts. Survival of statin-treated patients with single ITA grafts was similar to bilateral ITA patients. (Ann Thorac Surg 2009; 88: 789-95) (C) 2009 by The Society of Thoracic Surgeons