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(Circulation. 2007;115:677.)
© 2007 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	IMPACT OF PATIENT AND TARGET-VESSEL CHARACTERISTICS ON ARTERIAL AND VENOUS BYPASS GRAFT PATENCY: INSIGHT FROM A RANDOMIZED TRIAL, by Desai et al.

 
The excellent long-term patency rates for the left internal thoracic artery have made it the bypass conduit gold standard. The radial artery has emerged as an alternative coronary bypass conduit to the saphenous vein in an attempt to achieve arterial revascularization. Desai and colleagues report the results of a multicenter randomized clinical trial to determine the impact of patient and target-vessel characteristics on coronary bypass graft patency. Angiographic data on 440 radial artery and 440 saphenous vein grafts were analyzed. Multivariable models were constructed to determine predictors of graft occlusion. Radial artery use was strongly protective against graft occlusion at 1 year, with a larger protective effect seen in women. Among all grafts, diabetes and small target-vessel diameter were associated with an increased risk of graft occlusion. Grafting to a target vessel with more severe proximal stenosis was associated with a decreased risk of graft occlusion. The authors concluded that patients benefit from radial artery coronary artery bypass conduits as opposed to saphenous vein conduits, and this effect is especially strong in women. See p 684.

	RANDOMIZED COMPARISON OF A HIGH CLOPIDOGREL MAINTENANCE DOSE IN PATIENTS WITH DIABETES MELLITUS AND CORONARY ARTERY DISEASE: RESULTS OF THE OPTIMIZING ANTIPLATELET THERAPY IN DIABETES MELLITUS (OPTIMUS) STUDY, by Angiolillo et al.

 
Platelet inhibition has been shown to reduce cardiovascular events in high-risk patients. Inhibition of the P2Y12 platelet receptor with clopidogrel has been shown to be variable, and in some studies, a suboptimal response is associated with increased risk. Inadequate dosing has been suggested as one of the reasons for a suboptimal response. The study by Angiolillo et al was a randomized trial conducted in patients with type 2 diabetes mellitus and in whom . . . [Full Text of this Article]

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