Adoption and Effectiveness of Internal Mammary Artery Grafting in Coronary Artery Bypass Surgery Among Medicare Beneficiaries.

In this propensity matched analysis, Hlatky et al, investigate the adoption patterns of IMA grafting in the United States and study the association with clinical outcomes. They matched 60,896 Medicare patients with and without IMA grafts. The investigators found that IMA use was associated with lower rates of death (HR=0.77), death/MI (HR=0.77) and repeat revascularizations over a 5-year timeframe (8% vs. 9%, p<0.001). Also, IMA adoption grew between 1988 and 2008, and showed considerable geographic variation.