{ "abstract": "Objective\n\nAs the result of procedural complexity and risk of sternal wound infections, the adoption of multiarterial grafting (MAG) in coronary artery bypass surgery is lower in patients with diabetes despite a high prevalence of multivessel coronary artery disease. We conducted a randomized controlled study to evaluate the safety, graft patency at 1 year, and long-term survival at 5 years in MAG compared to single arterial grafting (SAG). This interim analysis reports 1-year mortality, morbidity, and graft patency.Methods\n\nA total of 950 patients with diabetes and multivessel coronary artery disease were enrolled between February 2022 and January 2025 at 15 hospitals across 7 states in India and randomized to SAG (n = 477) or MAG (n = 473) groups in a multicenter, prospective, randomized trial. Major adverse cardiac and cerebrovascular events and graft patency assessed by computed tomography coronary angiography at 1 year were analyzed (CTRI/2020/09/027692).Results\n\nOne-year composite outcome (SAG: n = 7 [1.5%] vs MAG: n = 7 [1.5%], P = .98) and mortality (SAG: n = 4 [0.8%] vs MAG: n = 6 [1.3%], P = .51) were low and comparable. Myocardial infarction occurred in 1 patient in each group. Stroke rates were comparable (SAG: n = 2 vs MAG: n = 1). One patient with SAG required repeat revascularization (percutaneous coronary intervention). Sternal wound infection occurred in 7 patients in the SAG group (1.5%) and 12 patients in the MAG group (2.6%) (P = .36). Sternal reconstruction was required in only 3 patients in the MAG group (0.6%). In total, 350 patients underwent protocol computed tomography graft angiography for graft assessment (SAG: n = 170, MAG: n = 180). Although overall graft patency did not differ between the SAG and MAG groups, vein graft patency was greater with MAG only after statistical adjustment for the effect of on-pump or off-pump status and involved coronary artery. Off-pump coronary artery bypass surgery, right internal mammary artery grafts, and right coronary artery and left circumflex coronary artery territory grafting were associated with lower overall graft patency.Conclusions\n\nInterim results from the trial demonstrate similar safety and 1-year clinical outcomes for SAG and MAG. We show superior venous graft patency with MAG after adjustment, but additional studies are required to validate this finding.", "abstract_shown": true, "affiliations": [ "Division of Cardiothoracic Surgery, Star Hospitals, Hyderabad, Telangana, India.", "Division of Clinical Research, Sajja Heart Foundation, Hyderabad, Telangana, India.", "Division of Cardiothoracic Surgery, Medica Super Speciality Hospital, Kolkata, West Bengal, India.", "Division of Cardiothoracic Surgery, GKNM Hospital, Coimbatore, Tamil Nadu, India.", "Division of Cardiothoracic Surgery, DDMM Heart Institute, Nadiad, Gujarat, India.", "Division of Cardiothoracic Surgery, Fortis Escorts Heart Institute, New Delhi, India.", "Division of Cardiothoracic Surgery, Care Institute of Medical Sciences (CIMS), Ahmedabad, Gujarat, India.", "Division of Cardiothoracic Surgery, Krishna Institute of Medical Sciences (KIMS), Hyderabad, Telangana, India.", "Division of Radiology, Star Hospitals, Hyderabad, Telangana, India.", "Department of Statistics, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India.", "Division of Cardiothoracic Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.", "Division of Cardiothoracic Surgery, U. N. Mehta Institute of Cardiology & Research Centre, Ahmedabad, Gujarat, India.", "Division of Cardiothoracic Surgery, Reliance Foundation Hospital, Mumbai, Maharashtra, India.", "Division of Cardiothoracic Surgery, Medway Heart Institute, Chennai, Tamil Nadu, India.", "Division of Cardiothoracic Surgery, All India Institute of Medical Sciences, New Delhi, India.", "Division of Cardiothoracic Surgery, Manipal Hospitals, New Delhi, India.", "Division of Cardiothoracic Ssurgery, Fortis Hospitals, Bangalore, Karnataka, India.", "Division of Cardiothoracic Surgery, SIMS Hospitals, Chennai, Tamil Nadu, India." ], "article_type": "research article", "arxiv": null, "author_total": 21, "authors": [ { "affs": [ 0, 1 ], "name": "Lokeswara Sajja" }, { "affs": [ 2 ], "name": "Kunal Sarkar" }, { "affs": [ 0 ], "name": "Gopichand Mannam" }, { "affs": [ 3 ], "name": "Chandrasekar Padmanabhan" }, { "affs": [ 4 ], "name": "Sanjeeth Peter" }, { "affs": [ 5 ], "name": "Zile Singh Meharwal" }, { "affs": [ 1 ], "name": "Aditya Koppula" }, { "affs": [ 6 ], "name": "Dhiren Shah" }, { "affs": [ 7 ], "name": "Venkata Krishna Kumar Kodali" }, { "affs": [ 8 ], "name": "Shruthi Kalyan Athni" }, { "affs": [ 9 ], "name": "Balakrishna Nagalla" }, { "affs": [ 1 ], "name": "Sateesh Sreeramula" }, { "affs": [ 10 ], "name": "Lalit Kapoor" }, { "affs": [ 11 ], "name": "Chirag Doshi" }, { "affs": [ 12 ], "name": "Anvay Mulay" }, { "affs": [ 13 ], "name": "Anbarasu Mohanraj" }, { "affs": [ 14 ], "name": "Milind Hote" }, { "affs": [ 15 ], "name": "Yugal Mishra" }, { "affs": [ 16 ], "name": "Vivek Jawali" }, { "affs": [ 17 ], "name": "Bashi Velayudhan" }, { "affs": [ 10 ], "name": "Pradeep Narayan" } ], "bibtex": "https://research.draconitic.com/paper/ahjhekkezdmpt.bib", "cited_by": 0, "doi": "10.1016/j.xjon.2026.102066", "fulltext_url": "https://europepmc.org/articles/PMC13711290", "id": "ahjhekkezdmpt", "issns": [ "2666-2736" ], "landing_url": "https://europepmc.org/article/MED/42948524", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Adult: Coronary: Clinical Trial" ], [ "openalex", "2746|Cardiac and Coronary Surgery Techniques" ] ], "openalex": "W7203737427", "pdf_url": "https://europepmc.org/articles/PMC13711290?pdf=render", "pmcid": "PMC13711290", "pmid": "42948524", "published": "2026-08-19", "publisher": "Elsevier", "ris": "https://research.draconitic.com/paper/ahjhekkezdmpt.ris", "sources": [ { "first_seen": "2026-10-31T00:20:35Z", "native_id": "MED:42948524", "source": "europepmc", "url": "https://europepmc.org/article/MED/42948524" }, { "first_seen": "2026-10-31T12:22:05Z", "native_id": "PMC13711290", "source": "pmc", "url": "https://doi.org/10.1016/j.xjon.2026.102066" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2746|Cardiac and Coronary Surgery Techniques", "subfield": "surgery" } ], "title": "Prospective Randomized Evaluation of DIabetics for graft patency and outcomes following Coronary artery bypass grafting using one (single) versus two or More (mulTi) arterial grafts (PREDICT) trial.", "title_text": "Prospective Randomized Evaluation of DIabetics for graft patency and outcomes following Coronary artery bypass grafting using one (single) versus two or More (mulTi) arterial grafts (PREDICT) trial.", "type": "peer-reviewed", "updated_at": "2026-10-31T12:22:05Z", "url": "https://research.draconitic.com/paper/ahjhekkezdmpt", "venue": "JTCVS open", "versions": [] }