Age–gender considerations on survival in patients undergoing radial artery grafting

ary graft. We performed subgroup analysis to delineate the effect of age, gender and diabetes. We showed that CABG using the RA in combination with the LITA-to-LAD group is associated with improved long-term overall survival (P = 0.03). The long-term data allowed delineation of the clinical benefi tb eginning at 5 years postoperatively. Median follow-up was 9.4 (interquartile range 5.7–11.9) years. Follow-up in the RA subgroup was 10.3 (interquartile range 5.7–11.9) years. Statistically, the benefit was most pronounced in the following order: diabetics (P = 0.005), women (P = 0.02) and the elderly (P = 0.04) [2]. The use of RA for CABG has undisputable advantages: the length of the conduit per se (approximately around 20 cm), its large diameter, its exposure to arterial blood pressure, the thickness of the wall and its lower susceptibility to atherogenesis. There is a difference in survival between males and females using RA as a second conduit for the following reasons. Receptor-mediated (acetylcholine-induced) and receptor-independent (calcium ionophore-induced) factors modulate endothelium relaxation. Shapira et al. [3] have shown enhanced physiological characteristics related to endothelial production or vessel relaxation in response to nitric oxide in RA when compared with other conduits.