Abstract 17330: Demographic Factors Associated With Disparity in Radial Artery Usage in Coronary Artery Bypass Graft Surgery: Insights From the National Inpatient Sample

Abstract

Introduction: The choice of graft for revascularization in coronary artery bypass grafting (CABG) impacts surgical outcomes. While both radial artery (RA) and greater saphenous vein (GSV) are options for secondary conduits to the left internal mammary artery (LIMA), RA graft usage is associated with better patency and better long-term survival benefit. However, equity of RA conduit usage in CABG is unknown. This study aimed to examine demographic factors associated with disparity of RA grafting among patients undergoing CABG. Methods: The National Inpatient Sample (NIS) was used to extract patients received who underwent CABG between Q4 2015-2020 based on ICD10-PCS. Patients less than the age of 40 were excluded for congenital heart defects. Preoperative variables include sex, age, race and ethnicity, socioeconomic status (SES), Elixhauser comorbidities, and hospital characteristics. The rate of RA usage with respect to race, sex, and SES was compared, respectively, while all preoperative variables besides the variable of interest were adjusted by multivariable analysis. Results: There were 56,318 CABG cases identified in the NIS with 11,708 RA and 44,610 GSV grafting. African American race (aOR 0.78, p<0.01), Hispanic race (aOR 0.83, p<0.01), female sex (aOR 0.53, p<0.01), and lower income (0-25 percentile, aOR 0.78, p<0.01; 25-50 percentile, aOR 0.95, p=0.04) were independently associated with lower rates of RA grafting usage among patients who underwent CABG. Conclusion: This study reveals disparities in RA graft usage for CABG, including racial minorities, women, and economically disadvantaged groups who were less likely to receive RA. These findings highlight the need for healthcare equity in choosing the optimal graft conduit in CABG.