Extensive BITA Grafting in the Canary Islands: an IPTW Analysis

NCT07796750 | Completed

• 1 other identifier: BITA-SURV
• Study Type: observational
• Target: 666
• Locations: 1 country
• Sites: 1

Brief Summary

Coronary artery bypass grafting (CABG) remains the preferred revascularization strategy for patients with complex multivessel coronary artery disease. The left internal thoracic artery is universally accepted as the standard conduit for grafting the left anterior descending artery, but the long-term clinical benefit and safety of bilateral internal thoracic artery (BITA) grafting compared with single internal thoracic artery (SITA) grafting remain debated. This retrospective cohort study compares long-term outcomes after BITA versus SITA grafting in consecutive adult patients undergoing first-time isolated CABG with at least two coronary grafts between May 1, 2017 and October 31, 2025 at Hospital Universitario de Gran Canaria Dr. Negrin. The primary endpoint is all-cause mortality during follow-up. Secondary outcomes include cardiovascular mortality, non-cardiovascular mortality, deep sternal wound infection, stroke, myocardial infarction, repeat coronary revascularization, and major adverse cardiovascular events (MACE). Treatment groups will be balanced using stabilized inverse probability of treatment weighting derived from a multivariable propensity score model including clinically relevant baseline variables. Long-term outcomes will be analyzed using weighted Kaplan-Meier survival curves and Cox proportional hazards regression.

Conditions

Coronary Artery Disease; Coronary Artery Bypass Grafting; Myocardial Revascularization

Keywords

CABG; Bilateral Internal Thoracic Artery; BITA; Single Internal Thoracic Artery; SITA; Multiple Arterial Grafting; Long-Term Survival; Cause-Specific Mortality; Cardiovascular Mortality; Deep Sternal Wound Infection; DSWI; Propensity Score; Inverse Probability of Treatment Weighting; IPTW; Observational Cohort; Cardiac Surgery

Outcome Measures

Primary Outcomes (1)

• All-cause mortality

  Death from any cause occurring after coronary artery bypass graft surgery.

  From coronary artery bypass graft surgery until death or last available clinical follow-up, with maximum follow-up through October 31, 2025. (107 months)

Secondary Outcomes (7)

• Cardiovascular mortality

  From surgery until death or last available follow-up, with maximum follow-up through October 31, 2025. (107 months)

• Non-cardiovascular mortality

  From surgery until death or last available follow-up, with maximum follow-up through October 31, 2025. (107 months)

• Deep sternal wound infection

  Postoperative period through available follow-up. (107 months)

• Stroke

  From surgery until last available clinical follow-up, with maximum follow-up through October 31, 2025. (107 months)

• Myocardial infarction

  From surgery until last available clinical follow-up, with maximum follow-up through October 31, 2025. (107 months)

Study Arms (2)

Bilateral Internal Thoracic Artery Grafting (BITA)

Patients receiving bilateral internal thoracic artery grafts as part of the myocardial revascularization procedure. Additional radial artery or saphenous vein grafts could be used whenever required to achieve complete revascularization.

Single Internal Thoracic Artery Grafting (SITA)

Patients receiving one internal thoracic artery together with additional saphenous vein and/or radial artery grafts according to surgeon preference.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients undergoing first-time isolated coronary artery bypass grafting in whom at least two coronary artery grafts were performed. Patients undergoing a single coronary artery graft were excluded.

You may qualify if:

• Age 18 years or older.
• First-time isolated coronary artery bypass grafting.
• At least two coronary artery grafts performed.
• Surgery performed between May 1, 2017 and October 31, 2025.
• Complete information regarding surgical grafting strategy.
• Available follow-up.

You may not qualify if:

• Previous coronary artery bypass grafting.
• Single coronary artery graft only.
• Concomitant cardiac surgical procedures.
• Missing information regarding arterial grafting strategy.
• Missing follow-up data.
• Missing essential baseline variables preventing propensity score estimation.

Sponsors & Collaborators

• Hospital Universitario de Gran Canaria Doctor Negrín: lead

Study Sites (1)

Hospital Universitario de Gran Canaria Dr. Negrin

Las Palmas de Gran Canaria, Spain

Location

MeSH Terms

Conditions

Coronary Artery Disease

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Officials

• Ignacio Juarez del Rio, MD

  Department of Cardiac Surgery, Hospital Universitario de Gran Canaria Dr. Negrin

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ignacio Juarez del Rio, MD

Study Record Dates

• First Submitted: August 24, 2026
• First Posted: September 1, 2026
• Study Start: January 1, 2024
• Primary Completion: May 31, 2026
• Study Completion: June 30, 2026
• Last Updated: September 1, 2026

Record last verified: 2026-08

Locations

ES (1)