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.

@article{sajja2026prospective,
  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.}},
  author = {Lokeswara Sajja and Kunal Sarkar and Gopichand Mannam and Chandrasekar Padmanabhan and Sanjeeth Peter and Zile Singh Meharwal and Aditya Koppula and Dhiren Shah and Venkata Krishna Kumar Kodali and Shruthi Kalyan Athni and Balakrishna Nagalla and Sateesh Sreeramula and Lalit Kapoor and Chirag Doshi and Anvay Mulay and Anbarasu Mohanraj and Milind Hote and Yugal Mishra and Vivek Jawali and Bashi Velayudhan and Pradeep Narayan},
  journal = {JTCVS open},
  year = {2026},
  month = aug,
  doi = {10.1016/j.xjon.2026.102066},
  url = {https://europepmc.org/article/MED/42948524},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - 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.
AU  - Lokeswara Sajja
AU  - Kunal Sarkar
AU  - Gopichand Mannam
AU  - Chandrasekar Padmanabhan
AU  - Sanjeeth Peter
AU  - Zile Singh Meharwal
AU  - Aditya Koppula
AU  - Dhiren Shah
AU  - Venkata Krishna Kumar Kodali
AU  - Shruthi Kalyan Athni
AU  - Balakrishna Nagalla
AU  - Sateesh Sreeramula
AU  - Lalit Kapoor
AU  - Chirag Doshi
AU  - Anvay Mulay
AU  - Anbarasu Mohanraj
AU  - Milind Hote
AU  - Yugal Mishra
AU  - Vivek Jawali
AU  - Bashi Velayudhan
AU  - Pradeep Narayan
PY  - 2026
DA  - 2026/08/19
JO  - JTCVS open
DO  - 10.1016/j.xjon.2026.102066
UR  - https://europepmc.org/article/MED/42948524
AB  - Objective  As 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  A 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  One-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  Interim 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.
SN  - 2666-2736
ER  -