Clinical Outcomes of Surgical Treatment on Myocardial Bridging in Symptomatic Patients Running Title: Surgical treatment outcomes of myocardial bridging

Clinical Outcomes of Surgical Treatment on Myocardial Bridging in Symptomatic Patients Running Title: Surgical treatment outcomes of myocardial bridging | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Outcomes of Surgical Treatment on Myocardial Bridging in Symptomatic Patients Running Title: Surgical treatment outcomes of myocardial bridging Boyao Zhang, Mengwei Tan, Xingli Fan, Jie Lu, Guokun Wang, Jiajun Zhang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4180201/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background There is a paucity of data regarding surgical results of myocardial bridging(MB).Our study aimed to evaluate the clinical efficacy of surgical treatment including coronary artery bypass grafting (CABG) and unroofing for MB in symptomatic patients who had chest pain refractory to medical therapy.. Methods Among 124 adult patients diagnosed with myocardial bridging at our institution(2010–2019),85 underwent surgical intervention and 39 received medical treatment.To understand the potential benefit of surgical treatment,we excluded 21 patients with concomitant operations for other diagnoses or obstructive coronary disease.64 symptomatic patients with isolated left anterior descending(LAD) MB underwent surgical treatment,which included CABG for 56 patients and unroofing for 8 patients. All patients were followed up 1 to 10 years.We analyzed recurrent symptoms,postoperative medication use,and adverse cardiovascular events. Results Mean age was 60.9 ± 8.4 years(48 men [75%]).All patients underwent preoperative coronary angiography.Mean cardiopulmonary bypass and cross-clamp times were 53.5 ± 19.8 minutes and 24.0 ± 10.1 minutes,respectively.During follow-up(median, 28 months) there were no cardiac-related deaths.The reintervention rate after discharge in the operation group was lower than that in the non-operation group (14.3% vs. 35.9%, p = 0.027). The symptom improvement rate of patients in the operation group was higher than that in the non-operation group (82.8% vs 48.7%, p = 0.001). Through multivariate risk analysis, we found that antiplatelet strategies (p = 0.004, OR = 0.187, 95%CI = 0.059–0.594) were risk factors for graft restenosis in patients with CABG. Conclusions Surgical treatment can be performed safely and effectively in patients with chest pain and isolated LAD coronary artery myocardial bridging.However,patients should be aware of the potential for recurrent chest pain, and continued medical therapy was important. Myocardial bridge (MB) Surgical treatment Coronary artery bypass grafting (CABG) Unroofing Figures Figure 1 Figure 2 Introduction The myocardial bridge (MB) refers to the muscle covering the inner myocardial segment of the epicardial coronary artery that is compressed during systole, and is a common co ngenital coronary artery abnormality 1 . Coronary angiography, which is the diagnostic gold standard for MB,have demonstrated incidence of MB between 0.5% and 2.5%. Although MBs can be seen in any epicardial artery, they mostly involve the left anterior descending branch 2 . Although MBs are generally regarded as benign, there is a clear clinical correlation between myocardial ischemia and MBs, given that both myocardial ischemia and acute coronary syndrome associated with MBs are widely recognized 3 – 4 . Most of MB can be treated successfully with optimal medical therapy.However,some patients with proximal LAD MB,who produce >50% systolic compression of the involved coronary artery,can be symptomatic with postive noninvasive testing for ischemia and refractory to optimal medical therapy.In these cases,surgical treatment may be indicated.As there has always been controversy about indications for surgery, surgical methods, and the choice of postoperative anticoagulants, we analyzed the clinical and follow-up results of different treatments in symptomatic patients with isolated myocardial bridge. Patients and Methods Patient Selection From January 2010 to December 2019, 10,941 patients ≥ 50 years underwent selective coronary angiography in the Department of Cardiovascular Surgery, Shanghai Changhai Hospital, of which 124 patients were diagnosed with myocardial bridge using selective coronary arteriography (SCAG). Segmental coronary artery stenosis (> 50%) occurred only during contraction and recovered during diastole, suggesting the presence of MBs. The appearance of the "half-moon" phenomenon, that is, the half-moon phenomenon in the bridged segments, lasts for the whole cardiac cycle. However, it is not found in the proximal and distal segments, which is highly specific for MBs. If SCAG showed coronary artery stenosis ≥ 30% within at least two projection angles during contraction and recovers during diastole, representing the "milking effect,” it was diagnosed as MBs with mural coronary artery 4 . The incidence of myocardial bridge was 1.13%. Among the 124 patients, 19 patients who had moderate to severe aortic stenosis, hypertrophic cardiomyopathy, and coronary heart disease,were excluded; 103 patients with isolated LAD myocardial bridge were included. Fifty-six patients underwent coronary artery bypass grafting (CABG), eight patients underwent myocardial bridge unroofing, and 39 patients received medical treatment(Fig. 1). In this study,chart review from the electronic medical record was used to evaluate all available clinical visits,operative reports,and imaging.The patients who underwent surgical therapy and received medical treatment were analyzed and followed up. The surgical basis of the patients who underwent CABG was a ≥ 50% degree of myocardial bridge stenosis of the anterior descending branch as shown by coronary angiography, symptoms of angina pectoris, and refractory to optimal medical therapy.Our analysis examined demographic characteristics ,symptoms,comorbidities,catheterization,and postoperative complications.Long-term results focused on symptomatic outcomes,medication use ,and mortality.All data were collected from the database of the Division of Cardiothoracic Surgery under the permission of the Institutional Review Board of Changhai Hospital.This clinical trial was undertaken after receiving patients' consent.And all methods were performed in accordance with relevant guidelins and regulations. Operative intervention and Medications Surgical therapy was performed by median sternotomy.Cardiopulmonary bypass(CPB) was used with aortic cross-clamping and cardioplegic arrest in 46 patients. The operation began with identification of the LAD coronary artery beyond the intramyocardial portion.If the depth of MB less than 5mm, unroofing was firstly used.When the depth of MB more than 5mm,unroofing procedure unsuccessfully,or the myocardial bridge associated with coronary artery atherosclerosis or serious focal coronary spasm,CABG was carried out in time. The bridging vessels were the internal mammary artery or great saphenous vein. The on-pump or off-pump was selected according to the heart condition of the patients. Most patients continued taking medications after their operations. 39 patients received medical treatment using beta-blockers, non-dihydropyridine calcium channel blockers,nitrates,statins and asprin. Follow-up All patients were followed up by telephone or outpatient services during hospitalization and 1 and 10 years after the operation. During the follow-up period, the patients' clinical symptoms, drug treatment strategy at discharge, medical intervention (drug change, hospitalization, and operation), heart-related events (myocardial infarction, other cardiac surgeries), electrocardiogram, and cardiac ultrasound were analyzed. The final clinical outcome evaluated was a reexamination of coronary angiography to observe stenosis of the reconstructed vascular bridge, with a degree of stenosis ≥ 70% considered as bridging vascular restenosis 5 . The secondary clinical outcome evaluated was whether the patient's subjective perception of the current symptoms of angina pectoris was better than before the operation or hospitalization. Statistical Analysis We used SPSS 25.0 statistical software (Department of statistics, Naval Medical University,Shanghai City, China)for data analysis. Continuous data with normal distribution were expressed as mean ± standard deviation (SD), while continuous data that did not conform to normal distribution were expressed as median and quartile range. The classified data were described as frequencies (percentages). Continuous data were analyzed using the independent sample t-test (normal distribution) or Mann-Whitney U test (skewness distribution), and the classified data were analyzed using the chi-square test. Multivariate logistic regression analysis was used to analyze the patency of the bridged vessels after MBs. Variables with P < 0.05 in univariate analysis were included in multivariate analysis as independent variables. The results were presented as odds ratios (OR) and 95% confidence interval (CI). Statistical significance was set at P < 0.05. The follow-up results of the Kaplan-Meier regression analysis of bridging vascular restenosis were plotted using R 4.1.3 statistical software (Department of statistics, Naval Medical University,Shanghai City, China), and the 95% CI was calculated. Results Except for 18 patiens who received off-pump CABG,the mean CPB time was 53.5 ± 19.8 minutes and mean cross-clamp time 24.0 ± 10.1 minutes..None of the patients in this study died during hospitalization and follow-up; only one patient had a myocardial infarction in the fifth year after the operation, and no major adverse cardiac events (MACEs) occurred in the remaining patients. In the baseline data of the two groups, the proportion of males in the operation group was higher than that in the non-operation group (75% vs. 51.3%, p = 0.017). The average age of patients in the operation group was higher than that in the non-operation group (60.95 ± 8.437 vs 53.15 ± 10.274, p = 0.001). The proportion of patients with severe angina pectoris and who received regular drug treatment was higher in the operation group than in the non-operation group, (66.1% vs. 43.6%, p = 0.030) and (73.2% vs. 41%, p = 0.02), respectively. The proportion of S-T segment changes was higher in the operation group than in the non-operation group (50% vs. 23.1%, p = 0.08). There were no significant differences in the other preoperative data (P > 0.05) (Table 1 ) . Table 1 Comparison of baseline data between surgery group and non-operated group Variables Total (n = 103) operated (n = 64) non-operated (n = 39) p Age, n (%) 57.75 ± 9.958 60.95 ± 8.437 53.15 ± 10.274 0.001 DOCS, n (%) 67.95 ± 15.097 69.55 ± 15.204 65.64 ± 14.831 0.216 Pre-LVEF 62.45 ± 5.962 63.02 ± 6.124 61.64 ± 5.701 0.270 Pre-LV, Median 92.86 ± 17.990 92 (85, 101.5) 90 (78,95) 0.471 Pre-LA, Median 45.25 ± 14.996 42.5 (38, 50.75) 40 (32,49) 0.701 sex, n (%) 0.017 female 35(33.9) 16(25) 19(48.7) male 68(66.1) 48(75) 20(51.3) Preoperative symptoms 0.030 mild 44(42.7) 21(32.8) 22(56.4) severe 59(57.2) 43(67.2) 17(43.6) hypertensive 0.919 yes 45(43.7) 28(43.8) 17(43.6) none 58(56.3) 36(56.2) 22(56.4) diabetes 0.710 yes 4(3.9) 2(3.1) 2(5.1) none 99(96.1) 62(96.9) 37(94.9) smoking 0.536 yes 22(21.4) 15(23.4) 7(17.9) none 81(78.6) 49(76.6) 32(82.1) HLP 0.498 yes 36(34.9) 24 (37.5) 12 (30.8) none 67(65.1) 40(62.5) 27(69.2) Ecg ST changes 0.008 yes 40(38.8) 32(50) 9(23.1) none 63(61.2) 32(50) 30(76.9) Regular medication 0.002 yes 62(60.2) 47(73.4) 16(41) none 41(39.8) 17(26.6) 23(59) DOCS, Degree of coronary stenosis; HLP:hyperlipidemia; Pre-ECG:changes of preoperative ECG ST; DCAC: Degree of coronary artery compression ; Pre-LV:Preoperative left ventricular volume; Pre-LA:Preoperative volume of left atrium; Pre-LVEF:Preoperative left ventricular systolic function From the follow-up results in this study, there were no deaths during hospitalization or after surgery in the operation and non-operation groups.12 patients (18.8%) in the operation group had S-T segment changes on ECG one week after operation. There was no significant difference in the incidence of the S-T segment between the two groups 3 years after discharge or in the left ventricular ejection fraction between the two groups. The postoperative symptom improvement rate was higher in the operation group than in the non-operation group (82.1% vs. 48.7%, p = 0.001), while the reintervention rate after discharge was lower in the operation group than that in the non-operation group (14.3% vs. 35.9%, p = 0.027). The postoperative left ventricular diameter was smaller in the operation group than in the non-operation group (79 vs. 95, p = 0.001). The symptom improvement rate of patients in the operation group is higher than that in the non-operation group (82.1% vs 48.7%, p = 0.001) ( Table 2 ). Table 2 Comparison of follow-up results between surgical and drug groups Variables Total (n = 103) non-operated (n = 39) operated (n = 64) p Po-op symptom, n (%) 0.001 improvement 70 (68.0) 19 (48.7) 53 (82.8) invalid 33 (32.0) 20 (51.3) 11 (17.2) Intervention, n (%) 0.027 none 79 (76.7) 25 (64.1) 55 (85.9) yes 24 (23.3) 14 (35.9) 9 (14.1) death, n (%) 1 none 103 (100) 39 (100) 64 (100) ECG1, n (%) < 0.001 none 49 (47.5) 0 (0) 52 (81.2) yes 12 (11.6) 0 (0) 13 (18.8) NA 42 (40.9) 39 (100) 0 (0) ECG2, n (%) 0.284 none 55 (53.4) 24 (61.5) 31 (48.4) yes 48 (46.6) 15 (38.5) 33 (51.6) LVEF, Mean ± SD 60.5 ± 5.4 61.6 ± 5.7 59.7 ± 5.1 0.089 LV, Median (Q1,Q3) 88 (75.5, 96) 95 (81.5, 104.5) 79 (73.8, 92.2) < 0.001 LA, Median (Q1,Q3) 42 (37.5, 52.5) 43 (37, 55) 42 (38, 50.5) 0.628 MR, n (%) 0.003 none 79 (76.7) 25 (64.1) 55 (85.9) yes 17 (16.5) 8 (20.5) 9 (14.1) NA 7 (6.8) 6 (15.4) 0 (0) Po-op symptom:Postoperative symptom changes; ECG1:Ecg changes one week after operation; ECG2: Ecg changes three years after operation; Pre-ECG:changes of preoperative ECG ST; LV:left ventricular volume; LA:volume of left atrium; LVEF:left ventricular systolic function; MR:mitral regurgitation; The patients in the CABG group were divided into the bridging vessel patency group (graft patency, n = 27) and restenosis group (graft stenosis, n = 29) according to whether the bridging vessels were patent. In the baseline data of the two groups, the average age of patients in the restenosis group was higher than that in the bridge patency group (63.8 ± 7.7 vs 57.9 ± 8.2, p = 0.008). The different postoperative antiplatelet strategies suggested that the proportion of aspirin antibodies in the restenosis group was higher than that in the patency group (72.4% vs. 40.7%, p = 0.031). No significant differences were observed in the other data (Table 3 ). Univariate risk analysis revealed that the age of the surgical patients (p = 0.016, OR = 1.099, 95%CI = 1.018–1.187) and different postoperative antiplatelet drug strategies (p = 0.004, OR = 0.187, 95%CI = 0.059–0.594) were risk factors for graft restenosis in patients undergoing CABG. Multivariate risk analysis suggested that different postoperative antiplatelet drug strategies (p = 0.014, OR = 0.224, 95%CI = 0.068–0.736) were independent risk factors for restenosis after CABG in patients with myocardial bridge, suggesting that the aspirin + tigrel / clopidogrel dual antiplatelet prescription as a protective factor was 1.224 times lower than aspirin alone in preventing platelet bridging restenosis ( Table 4 ). Table 3 Comparison of bridge patency and restenosis after CABG Variables Total (n = 56) Graft patency (n = 27) Graft stenosis (n = 29) p sex, n (%) 1 female 14 (25) 7 (25.9) 7 (24.1) male 42 (75) 20 (74.1) 22 (75.9) age, Mean ± SD 60.9 ± 8.4 57.9 ± 8.2 63.8 ± 7.7 0.008 symptom, n (%) 1 mile 19 (33.9) 9 (33.3) 10 (34.5) severe 37 (66.1) 18 (66.7) 19 (65.5) Hypertension, n (%) 0.81 none 31 (55.4) 14 (51.9) 17 (58.6) yes 25 (44.6) 13 (48.1) 12 (41.4) Diabetes, n (%) 0.492 none 54 (96.4) 27 (100) 27 (93.1) yes 2 (3.6) 0 (0) 2 (6.9) Smoking, n (%) 0.883 none 43 (76.8) 20 (74.1) 23 (79.3) yes 13 (23.2) 7 (25.9) 6 (20.7) HLP, n (%) 0.73 normal 35 (62.5) 18 (66.7) 17 (58.6) high 21 (37.5) 9 (33.3) 12 (41.4) drug, n (%) 0.871 none 15 (26.8) 8 (29.6) 7 (24.1) yes 41 (73.2) 19 (70.4) 22 (75.9) DCAC, Median (Q1,Q3) 75 (50, 80) 75 (50, 80) 75 (60, 80) 0.202 ECG, n (%) 0.285 none 28 (50) 11 (40.7) 17 (58.6) yes 28 (50) 16 (59.3) 12 (41.4) LV, Median (Q1,Q3) 92 (85, 100.5) 91 (87.5, 103) 93 (83, 99) 0.594 LA, Median (Q1,Q3) 42.5 (38, 50.2) 44 (37.5, 49.5) 40 (38, 52) 0.98 MR, n (%) 1 0 48 (85.7) 23 (85.2) 25 (86.2) 1 8 (14.3) 4 (14.8) 4 (13.8) LVEF, Median (Q1,Q3) 64 (59.8, 67) 65 (60.5, 67) 63 (59, 66) 0.332 BV, n (%) 1 LIMA 45 (80.4) 22 (81.5) 23 (79.3) SV 11 (19.6) 5 (18.5) 6 (20.7) C-time, Median (Q1,Q3) 53.5 (40, 61) 53 (43.5, 62.5) 54 (36, 60) 0.522 A-time, Median (Q1,Q3) 24 (17.8, 33) 23 (18.5, 35) 24 (18, 29) 0.46 antiplatelet, n (%) 0.031 ASA 32(57.1) 11 (40.7) 21 (72.4) DAPT 24 (42.9) 16 (59.3) 8 (27.6) betablocker, n (%) 1 none 4 (7.1) 2 (7.4) 2 (6.9) yes 52 (92.9) 25 (92.6) 27 (93.1) statins, n (%) 0.228 none 2 (3.6) 2 (7.4) 0 (0) yes 54 (96.4) 25 (92.6) 29 (100) Diltiazem, n (%) < 0.001 none 37 (66.1) 26 (96.3) 11 (37.9) yes 19 (33.9) 1 (3.7) 18 (62.1) Postoperative symptoms, n (%) 0.019 improvement 46 (82.1) 27 (100.0) 19(65.5) invalid 10 (17.9) 0 (0) 10 (34.5) • HLP:hyperlipidemia; DCAC:Degree of coronary artery compression; ECG: ST changes in preoperative ECG; LV:left ventricular volume; LA:volume of left atrium; LVEF:left ventricular systolic function;MR:Preoperative mitral regurgitation;BV:saphenous vein bypass graft; LIMA:internal mammary artery; SVG:saphenous vein graft; C-time: cardiopulmonary bypass time; B-time:aortic crossclamp time; ASA:Aspirin antiplatelet; DAPT:Dual AntiPlatelet Therapy; Table 4 Univariate analysis and multivariate analysis of the influencing factors of vascular patency rate after CABG univariate analysis multivariate analysis Variables p OR 95%CI p OR 95%CI sex, n (%) 0.877 1.100 0.328 3.689 age, Mean ± SD 0.016 1.099 1.018 1.187 0.200 1.050 0.974 1.133 symptom, n (%) 0.928 0.950 0.314 2.875 Hypertension, n (%) 0.611 0.760 0.264 2.186 Smoking, n (%) 0.643 0.745 0.215 2.587 HLP, n (%) 0.535 1.412 0.475 4.196 drug, n (%) 0.643 1.323 0.404 4.331 stenosis, Median (Q1,Q3) 0.201 1.024 0.988 1.061 ECG, n (%) 0.423 0.650 0.226 1.866 LV, Median (Q1,Q3) 0.601 0.992 0.961 1.023 LA, Median (Q1,Q3) 0.327 1.023 0.978 1.069 LVEF, Median (Q1,Q3) 0.497 0.970 0.888 1.059 Bridging selection,n(%) 0.901 0.917 0.233 3.600 C-time, Median (Q1,Q3) 0.263 0.990 0.973 1.007 A-time, Median (Q1,Q3) 0.601 0.993 0.966 1.020 antiplatelet, n (%) 0.004 0.187 0.059 0.594 0.014 0.224 0.068 0.736 • HLP:hyperlipidemia; ECG: ST changes in preoperative ECG; LV:left ventricular volume; LA:volume of left atrium; LVEF:left ventricular systolic function; BV:saphenous vein bypass graft; C-time: cardiopulmonary bypass time; B-time:aortic crossclamp time; The 10-year follow-up results of the two groups by Kaplan-Meier analysis showed that the patency rate of bridging vessels in the DAPT group was higher than that in the ASA group (59.3% vs. 40.7%, p = 0.0093). Additionally, 43.4% of the patients in the ASA group developed bridging vascular restenosis in the fourth year, and 52.1% of the patients in the DAPT group still had bridging vascular restenosis in the sixth year ( Table 5 and Fig. 2). Comment MBs can be seen in any epicardial artery, but most MBs (70–98%) involve the left anterior descending branch. Currently, the most popular and effective examination method is coronary angiography, which determines the existence of MBs by identifying “milking signs”. The reported incidence of MBs is 1.5–16%, and the detection rate can increase to 40% after intracoronary injection of nitroglycerin 3 – 5 . Although MBs are considered benign, with the gradual deepening of the understanding of MBs, a series of complications caused by MBs have been widely recognized. In recent years, some researchers have considered MBs to be an independent risk factor for coronary atherosclerosis 6 . It has been reported that vasospasm caused by MBs may not only be the cause of myocardial ischemia and ventricular fibrillation and cardiac arrest but also lead to myocardial fibrosis, contractile band necrosis, and increased vascular density, which is closely related to myocardial insufficiency, angina pectoris, acute myocardial infarction and malignant arrhythmia 7 , 8 . Biomechanical changes caused by MBs are also the basis of its complications, such as plaque vulnerability, thrombosis, and vasospasm. Prolonged contraction of the MBs caused by delayed ventricular relaxation may damage early congested diastolic blood flow and local coronary artery spasm, which lasts to diastole because the relaxation time of arterial vascular smooth muscle is later than that of diastole, especially tachycardia. This further worsens coronary perfusion, resulting in diastolic blood flow damage with two secondary pathophysiological consequences, which were related to heart rate and the severity and duration of epicardial artery compression 9 . A recent study has shown that MBs may increase the risk of atherosclerosis in the proximal LAD of MBs, especially in patients with cardiovascular disease risk factors, including age, male sex, smoking, diabetes, hypertension, hyperlipidemia, and a family history of cardiovascular disease 10 . In summary, MBs may lead to significant cardiovascular consequences (MACE, myocardial ischemia), which require continued follow-up and medical intervention. The treatment strategy for myocardial bridge remains controversial. Schwarz et al. 11 proposed that β-blockers have negative chronotropic and inotropic effects, making them one of the first choices for MBs drug therapy. MBs drug therapy focuses on alleviating the potential triggers of aggravating MBs and hemodynamic disorders such as hypertension, myocardial hypertrophy, increased heart rate, and abnormal coronary artery contraction. Calcium channel blockers can reduce myocardial ischemia caused by coronary spasms. Vasodilators, such as nitroglycerin and isosorbide dinitrate, may aggravate the reversal of blood flow from the proximal coronary segment to MBs, resulting in local coronary systolic compression, tachycardia, and proximal vasodilation. However, drug therapy does not fundamentally address the environment of MBs. With increasing age, the prolonged contraction of MBs caused by delayed ventricular relaxation may affect early diastolic blood flow filling, thus shortening the diastolic perfusion time. At the same time, it also leads to locally related coronary spasm, which lasts to the diastolic phase, and finally leads to subendocardial ischemia and interventricular septal ischemia, which is caused by intramural blood theft or branching blood theft. Therefore, the symptoms of angina pectoris in patients without coronary revascularization are usually difficult to reduce with drug treatment, and the frequency of angina pectoris gradually increases with age. Long-term ischemia of the endocardium and interventricular septum in patients will further lead to left ventricular relaxation, followed by an increase in left ventricular volume, and finally require further treatment. The main reason for choosing surgery instead of coronary stents is that there are many complications associated with the latter, such as intraoperative perforation, stent rupture, in-stent restenosis, and thrombosis, and the results of long-term follow-up are not ideal 12 – 14 . MBs increase the incidence of stent restenosis after interventional therapy for proximal atherosclerotic lesions. According to follow-up, interventional therapy had a higher incidence of MACEs in patients with left anterior descending artery MBs with significant proximal stenosis, and the presence of MBs was significantly correlated with MACEs 15 . Therefore, the results of this study suggest that if there are symptoms of angina pectoris, changes in the S-T segment of the ECG, and the effect of regular drug treatment is poor, surgical treatment should opted for as soon as possible. Surgical unroofing and CABG have both advantages and disadvantages. Early complications of surgical myotomy include cardiac perforation, ventricular aneurysm formation, and postoperative bleeding. These complications are often serious and endanger the lives of patients. It is generally believed that when depth more than 5 mm or longer than 25 mm, CABG is better than unroofing 16 . In this study, the follow-up results of patients in the operation and non-operation groups showed that the improvement rate of angina pectoris in the operation group was significantly higher than that in the non-operation group. The reintervention rate of patients undergoing operation was significantly lower than that in the non-operation group. Some researchers believe that the target vessels need to be ligated to avoid competitive blood flow 17 . In this study, the coronary artery with the myocardial bridge was not ligated or clipped in the CABG operation, and the primary consideration was to reduce perioperative coronary artery injury, bleeding, ventricular perforation, and other serious complications. It can be found from previous literature that although there is a risk of bridging vessel occlusion caused by competitive blood flow inhibition, no severe stenosis or occlusion of bridging vessels was found during an average follow-up of 35 months 18 , 19 . However, the target vessels in patients with MBs are difficult to block spontaneously. During our follow-up, we found that in some patients with stenosis and occlusion of the bridging vessels, there was no obvious stenosis of the target vessels during ventricular diastole, which meant that competitive blood flow existed for a long time. Therefore, it was found that 50% of the patients had bridge stenosis or occlusion during follow-up. However, what is interesting is that although these patients had serious stenosis or occlusion of the bridging vessels, their subjective clinical symptoms, namely angina pectoris, were significantly better than those before the operation. Current research results cannot explain this phenomenon well. From the follow-up results of ASA versus DAPT in this study, it can be suggested that although there has been competitive blood flow inhibition in patients with MBs after CABG, which leads to bridging vascular stenosis, dual antiplatelet therapy remains an effective antiplatelet strategy to prevent bridging vascular stenosis. Bridging vessel restenosis may not affect the survival outcome of patients after surgery. The authors believe that CABG surgery delayed the negative effect of MBs on the left ventricular myocardium to some extent, and the left ventricular volume did not continue to increase and tended to return to normal volume in the presence of the bridge. Owing to the short follow-up time, no changes in the left ventricular myocardium were observed after stenosis and occlusion of the bridging vessels. The authors speculated that if the follow-up time continues to be prolonged, cardiac function changes and ECG changes may occur later in patients with patency of bridging vessels than in patients with bridging vessel stenosis. This study has some limitations. First, it was a single-center retrospective study, and the data may be biased due to the small sample size; thus, prospective, multicenter studies are needed to confirm our conclusions. Second, we did not compare the outcomes of surgical unroofing and CABG because the number of unroofing surgeries was little. This study suggests that surgical treatment can be performed safely and effectively in patients with chest pain and isolated LAD coronary artery myocardial bridging.However,patients should be aware of the potential for recurrent chest pain, and continued medical therapy was important. Figure 1.Among 124 patients with the diagnosis of myocardial bridging,103 with isolated MB received surgical or medical treatment after applying the specified inclusion and exclusion criteria. Figure 2. The 10-year follow-up results of the two groups by Kaplan-Meier analysis. The patency rate of bridging vessels in the DAPT group was higher than that in the DAPT group (59.3% vs. 40.7%, p = 0.0093). Additionally, 43.4% of the patients in the ASA group developed bridging vascular restenosis in the fourth year, and 52.1% of the patients in the DAPT group still had bridging vascular restenosis in the sixth year. Abbreviations MB myocardial bridge CABG coronary artery bypass grafting SCAG Selective coronary arteriography SD standard deviation OR odds ratios CI confidence interval MACEs major adverse cardiac events DAPT dual antiplatelet prescription ECG electrocardiograph ASA asprin Declarations All experimental protocols were approved by the Ethical Committee of Changhai Hospital affiliated with Naval Medical University. Informed consent has been waived by the Ethical Committee of Changhai Hospital affiliated with Naval Medical University.All data were collected from the database of the Division of Cardiothoracic Surgery under the permission of the Institutional Review Board of Changhai Hospital.This clinical trial was undertaken after receiving patients' consent.And all methods were performed in accordance with relevant guidelins and regulations. Funding Statement: The authors do not have any possible conflicts of interest Author Contribution Contributions: (I) Conception and design: Boyao Zhang#, Mengwei Tan#, Xingli Fan#, Jie Lu, Guokun Wang, Jiajun Zhang,Lin Han Yangfeng Tang; (II) Administrative support: L Han; (III) Provision of study materials or patients: Boyao Zhang, Mengwei Tan, Xingli Fan; (IV) Collection and assembly of data: Boyao Zhang, Mengwei Tan, Jie Lu; (V) Data analysis and interpretation: Boyao Zhang, Guokun Wang;(VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. The authors do not have any possible conflicts of interest Acknowledgement None Data Availability Data is provided within the manuscript or supplementary information files. Informed Patient Consent All patients in this study signed informed consent documents. References Lee MS, Chen C-H. Myocardial Bridging: An Up-to-Date Review. J Invasive Cardiol. 2015;27(11):521–8. Giuseppe Tarantini F, Migliore F, Cademartiri C, Fraccaro S, Iliceto, et al. Left Anterior Descending Artery Myocardial Bridging: A Clinical Approach. J Am Coll Cardiol. 2016;68(25):2887–99. Fengping Y, Chen Y. A case of sudden death due to myocardial bridging of the left anterior descending coronary artery. Chin Med J (Engl). 2014;127(13):2553. Wen Gao J, Zhang F, Duan S, Guo C, Chen L, Du, et al. Clinical characteristics and factors associated with coronary stenosis proximal to a myocardial bridge: a retrospective study. BMC Cardiovasc Disord. 2020;20(1):371. Gaudino M, Benedetto U, Fremes S, Biondi-Zoccai G, Sedrakyan A, Puskas JD, et al. Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery. N Engl J Med. 2018;378(22):2069–77. Quarello E. [How I do… to assess an abnormality of the great vessels?]. Gynecol Obstet Fertil. 2009;37(4):349–52. Young-Jae Ki., Myocardial bridging presenting as myocardial ischaemia induced cardiac arrest: a case report. BMC Cardiovasc Disord, 2021. 21(1): p. 178. Erdogan HI, Gul EE, Hasan Gok., Gul, Gok H. Relationship between myocardial bridges and arrhythmic complications. J Invasive Cardiol, 2012. 24(11): pp. E300-2. Giuseppe Tarantini F, Migliore F, Cademartiri C, Fraccaro S. Iliceto., Left Anterior Descending Artery Myocardial Bridging: A Clinical Approach. J Am Coll Cardiol, 2016. 68(25): pp. 2887–2899. Ishikawa YA-FY, Mikami T, Akasaka Y. Toshiharu Ishii., Settlement of Stenotic Site and Enhancement of Risk Factor Load for Atherosclerosis in Left Anterior Descending Coronary Artery by Myocardial Bridge. Arterioscler ThroMBs Vasc Biol, 2018. 38(6): pp. 1407–1414. Schwarz ER, Klues HG, Dahl Jvom, Klein I, Krebs W, Hanrath P. Functional, angiographic and intracoronary Doppler flow characteristics in symptomatic patients with myocardial bridging: effect of short-term intravenous beta-blocker medication. J Am Coll Cardiol. 1996;27(7):1637–45. Anwar T, Brian K, Whisenant AD, Michaels. Stent fracture following stenting of a myocardial bridge: report of two cases. Catheter Cardiovasc Interv. 2008;71(2):191–6. Ernst A, Joško Bulum, Jadranka Šeparović Hanževački, Martina Lovrić Benčić, Strozzi M. Five-year angiographic and clinical follow-up of patients with drug-eluting stent implantation for symptomatic myocardial bridging in absence of coronary atherosclerotic disease. J Invasive Cardiol, 2013. 25(11): pp. 586 – 92. Prabhakar B, Kunamneni S, Rajdev P, Krishnan, Pedro R, Moreno MC, Kim SK, Sharma, Annapoorna S, Kini. Outcome of intracoronary stenting after failed maximal medical therapy in patients with symptomatic myocardial bridge. Catheter Cardiovasc Interv. 2008;71(2):185–90. Zhang Hao JX, Ahmed Z, Huanjun P, Zhanqi W, Yanfei W, et al. The Outcome of Percutaneous Coronary Intervention for Significant Atherosclerotic Lesions in Segment Proximal to Myocardial Bridge at Left Anterior Descending Coronary Artery. Int Heart J. 2018;59(3):467–73. Attaran S, Moscarelli M, Athanasiou T, Anderson J. Is coronary artery bypass grafting an acceptable alternative to myotomy for the treatment of myocardial bridging? Interact Cardiovasc Thorac Surg. 2013;16(3):347–9. Zou Y-X, Huang F-J, Wu Q, Zhu E-J. Graft occlusion after coronary artery bypass grafting and stent deformation and in-stent restenosis after succedent stenting in a patient with deep position myocardial bridging. Interact Cardiovasc Thorac Surg. 2012;15(3):537–9. Wu Qing-yu, Xu Zhong-hua. Surgical treatment of myocardial bridging: report of 31 cases. Chin Med J (Engl). 2007;120(19):1689–93. Huang X-H, Wang S-Y, Xu J-P, Song Y-H, Tang H-SSY, et al. Surgical outcome and clinical follow-up in patients with symptomatic myocardial bridging. Chin Med J (Engl). 2007;120(18):1563–6. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4180201","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":286579283,"identity":"da62b6b0-5410-4790-a5f2-60e7321b2ba8","order_by":0,"name":"Boyao Zhang","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Boyao","middleName":"","lastName":"Zhang","suffix":""},{"id":286579285,"identity":"7a536d20-f447-4280-a9b6-886e06cc7e94","order_by":1,"name":"Mengwei Tan","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Mengwei","middleName":"","lastName":"Tan","suffix":""},{"id":286579286,"identity":"8624f718-0936-41f0-8863-a5085c5482c9","order_by":2,"name":"Xingli Fan","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Xingli","middleName":"","lastName":"Fan","suffix":""},{"id":286579288,"identity":"443ee38a-8108-4ed3-a000-9842e25f63ab","order_by":3,"name":"Jie Lu","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Jie","middleName":"","lastName":"Lu","suffix":""},{"id":286579290,"identity":"b782b9b2-600b-4625-9101-cdceb599550d","order_by":4,"name":"Guokun Wang","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Guokun","middleName":"","lastName":"Wang","suffix":""},{"id":286579291,"identity":"0d88fd6d-8465-49fe-8383-bd7804e60efc","order_by":5,"name":"Jiajun Zhang","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Jiajun","middleName":"","lastName":"Zhang","suffix":""},{"id":286579292,"identity":"9e517081-eb64-462f-9950-7a9a8f3ec6b9","order_by":6,"name":"Lin Han","email":"","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Han","suffix":""},{"id":286579293,"identity":"c36f7f2f-f888-4ab0-a83c-7ce1f4ff9340","order_by":7,"name":"Yangfeng Tang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYNACG4YEfvb+hw8SKmoIK+YBk2kMCZI9Z5gNHpw5RoIWgxs+bJIPW5gJa7FnP3v4NU+CXR7DDd5jFYkNbAz87d0J+G3hyUuz5klILmac3Zd2I3GHDIPEmbMbCDgsx8yY98eBxGaZA2Y3Es+wMRhI5BLQwv/GzJgn4UBim0SCWUFiGzMRWiRyjB+DtPRI5JgxEKflxhszxjkJyYkzeI4lSyScOcZD0C/s/TnGH94k2CXuP9588OOPiho5/vZe/FqAgE2KB9laQspBgPnjD2KUjYJRMApGwcgFAAodS1KazlrhAAAAAElFTkSuQmCC","orcid":"","institution":"Changhai Hospital, Naval Medical University (Second Military Medical University)","correspondingAuthor":true,"prefix":"","firstName":"Yangfeng","middleName":"","lastName":"Tang","suffix":""}],"badges":[],"createdAt":"2024-03-28 07:09:33","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4180201/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4180201/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":54312434,"identity":"3af1ea96-5b58-4ae3-b296-80246294e661","added_by":"auto","created_at":"2024-04-08 17:22:17","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":111426,"visible":true,"origin":"","legend":"\u003cp\u003eAmong 124 patients with the diagnosis of myocardial bridging,103 with isolated MB received surgical or medical treatment after applying the specified inclusion and exclusion criteria.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4180201/v1/825f5eca452d0ad6ae353c54.jpg"},{"id":54312433,"identity":"057d4281-aaff-4c80-8c71-29b44c1ba4f1","added_by":"auto","created_at":"2024-04-08 17:22:17","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":39563,"visible":true,"origin":"","legend":"\u003cp\u003eThe 10-year follow-up results of the two groups by Kaplan-Meier analysis. The patency rate of bridging vessels in the DAPT group was higher than that in the DAPT group (59.3% vs. 40.7%, p=0.0093). Additionally, 43.4% of the patients in the ASA group developed bridging vascular restenosis in the fourth year, and 52.1% of the patients in the DAPT group still had bridging vascular restenosis in the sixth year.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4180201/v1/f75fff461349735ef1536cec.jpg"},{"id":62756853,"identity":"730e4b9c-74de-45f9-9bc5-e29f1360bcc2","added_by":"auto","created_at":"2024-08-19 06:48:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1000130,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4180201/v1/9a15eab2-98c9-4281-b29f-8da03a527d55.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Outcomes of Surgical Treatment on Myocardial Bridging in Symptomatic Patients Running Title: Surgical treatment outcomes of myocardial bridging","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe myocardial bridge (MB) refers to the muscle covering the inner myocardial segment of the epicardial coronary artery that is compressed during systole, and is a common co ngenital coronary artery abnormality\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Coronary angiography, which is the diagnostic gold standard for MB,have demonstrated incidence of MB between 0.5% and 2.5%. Although MBs can be seen in any epicardial artery, they mostly involve the left anterior descending branch\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Although MBs are generally regarded as benign, there is a clear clinical correlation between myocardial ischemia and MBs, given that both myocardial ischemia and acute coronary syndrome associated with MBs are widely recognized\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Most of MB can be treated successfully with optimal medical therapy.However,some patients with proximal LAD MB,who produce \u003e50% systolic compression of the involved coronary artery,can be symptomatic with postive noninvasive testing for ischemia and refractory to optimal medical therapy.In these cases,surgical treatment may be indicated.As there has always been controversy about indications for surgery, surgical methods, and the choice of postoperative anticoagulants, we analyzed the clinical and follow-up results of different treatments in symptomatic patients with isolated myocardial bridge.\u003c/p\u003e"},{"header":"Patients and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatient Selection\u003c/h2\u003e \u003cp\u003eFrom January 2010 to December 2019, 10,941 patients\u0026thinsp;\u0026ge;\u0026thinsp;50 years underwent selective coronary angiography in the Department of Cardiovascular Surgery, Shanghai Changhai Hospital, of which 124 patients were diagnosed with myocardial bridge using selective coronary arteriography (SCAG). Segmental coronary artery stenosis (\u0026gt;\u0026thinsp;50%) occurred only during contraction and recovered during diastole, suggesting the presence of MBs. The appearance of the \"half-moon\" phenomenon, that is, the half-moon phenomenon in the bridged segments, lasts for the whole cardiac cycle. However, it is not found in the proximal and distal segments, which is highly specific for MBs. If SCAG showed coronary artery stenosis\u0026thinsp;\u0026ge;\u0026thinsp;30% within at least two projection angles during contraction and recovers during diastole, representing the \"milking effect,\u0026rdquo; it was diagnosed as MBs with mural coronary artery \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. The incidence of myocardial bridge was 1.13%. Among the 124 patients, 19 patients who had moderate to severe aortic stenosis, hypertrophic cardiomyopathy, and coronary heart disease,were excluded; 103 patients with isolated LAD myocardial bridge were included. Fifty-six patients underwent coronary artery bypass grafting (CABG), eight patients underwent myocardial bridge unroofing, and 39 patients received medical treatment(Fig.\u0026nbsp;1). In this study,chart review from the electronic medical record was used to evaluate all available clinical visits,operative reports,and imaging.The patients who underwent surgical therapy and received medical treatment were analyzed and followed up. The surgical basis of the patients who underwent CABG was a\u0026thinsp;\u0026ge;\u0026thinsp;50% degree of myocardial bridge stenosis of the anterior descending branch as shown by coronary angiography, symptoms of angina pectoris, and refractory to optimal medical therapy.Our analysis examined demographic characteristics ,symptoms,comorbidities,catheterization,and postoperative complications.Long-term results focused on symptomatic outcomes,medication use ,and mortality.All data were collected from the database of the Division of Cardiothoracic Surgery under the permission of the Institutional Review Board of Changhai Hospital.This clinical trial was undertaken after receiving patients' consent.And all methods were performed in accordance with relevant guidelins and regulations.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eOperative intervention and Medications\u003c/h3\u003e\n\u003cp\u003eSurgical therapy was performed by median sternotomy.Cardiopulmonary bypass(CPB) was used with aortic cross-clamping and cardioplegic arrest in 46 patients. The operation began with identification of the LAD coronary artery beyond the intramyocardial portion.If the depth of MB less than 5mm, unroofing was firstly used.When the depth of MB more than 5mm,unroofing procedure unsuccessfully,or the myocardial bridge associated with coronary artery atherosclerosis or serious focal coronary spasm,CABG was carried out in time. The bridging vessels were the internal mammary artery or great saphenous vein. The on-pump or off-pump was selected according to the heart condition of the patients. Most patients continued taking medications after their operations.\u003c/p\u003e \u003cp\u003e39 patients received medical treatment using beta-blockers, non-dihydropyridine calcium channel blockers,nitrates,statins and asprin.\u003c/p\u003e\n\u003ch3\u003eFollow-up\u003c/h3\u003e\n\u003cp\u003eAll patients were followed up by telephone or outpatient services during hospitalization and 1 and 10 years after the operation. During the follow-up period, the patients' clinical symptoms, drug treatment strategy at discharge, medical intervention (drug change, hospitalization, and operation), heart-related events (myocardial infarction, other cardiac surgeries), electrocardiogram, and cardiac ultrasound were analyzed. The final clinical outcome evaluated was a reexamination of coronary angiography to observe stenosis of the reconstructed vascular bridge, with a degree of stenosis\u0026thinsp;\u0026ge;\u0026thinsp;70% considered as bridging vascular restenosis \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The secondary clinical outcome evaluated was whether the patient's subjective perception of the current symptoms of angina pectoris was better than before the operation or hospitalization.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eWe used SPSS 25.0 statistical software (Department of statistics, Naval Medical University,Shanghai City, China)for data analysis. Continuous data with normal distribution were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD), while continuous data that did not conform to normal distribution were expressed as median and quartile range. The classified data were described as frequencies (percentages). Continuous data were analyzed using the independent sample t-test (normal distribution) or Mann-Whitney U test (skewness distribution), and the classified data were analyzed using the chi-square test. Multivariate logistic regression analysis was used to analyze the patency of the bridged vessels after MBs. Variables with P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in univariate analysis were included in multivariate analysis as independent variables. The results were presented as odds ratios (OR) and 95% confidence interval (CI). Statistical significance was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05. The follow-up results of the Kaplan-Meier regression analysis of bridging vascular restenosis were plotted using R 4.1.3 statistical software (Department of statistics, Naval Medical University,Shanghai City, China), and the 95% CI was calculated.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eExcept for 18 patiens who received off-pump CABG,the mean CPB time was 53.5\u0026thinsp;\u0026plusmn;\u0026thinsp;19.8 minutes and mean cross-clamp time 24.0\u0026thinsp;\u0026plusmn;\u0026thinsp;10.1 minutes..None of the patients in this study died during hospitalization and follow-up; only one patient had a myocardial infarction in the fifth year after the operation, and no major adverse cardiac events (MACEs) occurred in the remaining patients. In the baseline data of the two groups, the proportion of males in the operation group was higher than that in the non-operation group (75% vs. 51.3%, p\u0026thinsp;=\u0026thinsp;0.017). The average age of patients in the operation group was higher than that in the non-operation group (60.95\u0026thinsp;\u0026plusmn;\u0026thinsp;8.437 vs 53.15\u0026thinsp;\u0026plusmn;\u0026thinsp;10.274, p\u0026thinsp;=\u0026thinsp;0.001). The proportion of patients with severe angina pectoris and who received regular drug treatment was higher in the operation group than in the non-operation group, (66.1% vs. 43.6%, p\u0026thinsp;=\u0026thinsp;0.030) and (73.2% vs. 41%, p\u0026thinsp;=\u0026thinsp;0.02), respectively. The proportion of S-T segment changes was higher in the operation group than in the non-operation group (50% vs. 23.1%, p\u0026thinsp;=\u0026thinsp;0.08). There were no significant differences in the other preoperative data (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of baseline data between surgery group and non-operated group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;103)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eoperated (n\u0026thinsp;=\u0026thinsp;64)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003enon-operated (n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57.75\u0026thinsp;\u0026plusmn;\u0026thinsp;9.958\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.95\u0026thinsp;\u0026plusmn;\u0026thinsp;8.437\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.15\u0026thinsp;\u0026plusmn;\u0026thinsp;10.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDOCS, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.95\u0026thinsp;\u0026plusmn;\u0026thinsp;15.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.55\u0026thinsp;\u0026plusmn;\u0026thinsp;15.204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.64\u0026thinsp;\u0026plusmn;\u0026thinsp;14.831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.216\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePre-LVEF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62.45\u0026thinsp;\u0026plusmn;\u0026thinsp;5.962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.02\u0026thinsp;\u0026plusmn;\u0026thinsp;6.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61.64\u0026thinsp;\u0026plusmn;\u0026thinsp;5.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.270\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePre-LV, Median\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92.86\u0026thinsp;\u0026plusmn;\u0026thinsp;17.990\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92 (85, 101.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90 (78,95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.471\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePre-LA, Median\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45.25\u0026thinsp;\u0026plusmn;\u0026thinsp;14.996\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.5 (38, 50.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 (32,49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.701\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esex, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(48.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68(66.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48(75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(51.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.030\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emild\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44(42.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(32.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(56.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esevere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59(57.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43(67.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17(43.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehypertensive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.919\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45(43.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(43.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17(43.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58(56.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(56.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(56.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ediabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.710\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99(96.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62(96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37(94.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22(21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(23.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(17.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81(78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(76.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32(82.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHLP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.498\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36(34.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (30.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67(65.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40(62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27(69.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEcg ST changes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40(38.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32(50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9(23.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63(61.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32(50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30(76.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular medication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62(60.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(73.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16(41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41(39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(26.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23(59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eDOCS, Degree of coronary stenosis; HLP:hyperlipidemia; Pre-ECG:changes of preoperative ECG ST; DCAC: Degree of coronary artery compression ; Pre-LV:Preoperative left ventricular volume; Pre-LA:Preoperative volume of left atrium; Pre-LVEF:Preoperative left ventricular systolic function\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFrom the follow-up results in this study, there were no deaths during hospitalization or after surgery in the operation and non-operation groups.12 patients (18.8%) in the operation group had S-T segment changes on ECG one week after operation. There was no significant difference in the incidence of the S-T segment between the two groups 3 years after discharge or in the left ventricular ejection fraction between the two groups. The postoperative symptom improvement rate was higher in the operation group than in the non-operation group (82.1% vs. 48.7%, p\u0026thinsp;=\u0026thinsp;0.001), while the reintervention rate after discharge was lower in the operation group than that in the non-operation group (14.3% vs. 35.9%, p\u0026thinsp;=\u0026thinsp;0.027). The postoperative left ventricular diameter was smaller in the operation group than in the non-operation group (79 vs. 95, p\u0026thinsp;=\u0026thinsp;0.001). The symptom improvement rate of patients in the operation group is higher than that in the non-operation group (82.1% vs 48.7%, p\u0026thinsp;=\u0026thinsp;0.001) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of follow-up results between surgical and drug groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;103)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003enon-operated (n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eoperated (n\u0026thinsp;=\u0026thinsp;64)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePo-op symptom, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eimprovement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (68.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (48.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53 (82.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003einvalid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33 (32.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (51.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79 (76.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (64.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55 (85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (23.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (35.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (14.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edeath, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECG1, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (47.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52 (81.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (40.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECG2, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.284\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55 (53.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (61.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (48.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (46.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLVEF, Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.6\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.7\u0026thinsp;\u0026plusmn;\u0026thinsp;5.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLV, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88 (75.5, 96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95 (81.5, 104.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79 (73.8, 92.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLA, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (37.5, 52.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (37, 55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42 (38, 50.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.628\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMR, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79 (76.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (64.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55 (85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (20.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (14.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (15.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003ePo-op symptom:Postoperative symptom changes; ECG1:Ecg changes one week after operation; ECG2: Ecg changes three years after operation; Pre-ECG:changes of preoperative ECG ST; LV:left ventricular volume; LA:volume of left atrium; LVEF:left ventricular systolic function; MR:mitral regurgitation;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe patients in the CABG group were divided into the bridging vessel patency group (graft patency, n\u0026thinsp;=\u0026thinsp;27) and restenosis group (graft stenosis, n\u0026thinsp;=\u0026thinsp;29) according to whether the bridging vessels were patent. In the baseline data of the two groups, the average age of patients in the restenosis group was higher than that in the bridge patency group (63.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.7 vs 57.9\u0026thinsp;\u0026plusmn;\u0026thinsp;8.2, p\u0026thinsp;=\u0026thinsp;0.008). The different postoperative antiplatelet strategies suggested that the proportion of aspirin antibodies in the restenosis group was higher than that in the patency group (72.4% vs. 40.7%, p\u0026thinsp;=\u0026thinsp;0.031). No significant differences were observed in the other data (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Univariate risk analysis revealed that the age of the surgical patients (p\u0026thinsp;=\u0026thinsp;0.016, OR\u0026thinsp;=\u0026thinsp;1.099, 95%CI\u0026thinsp;=\u0026thinsp;1.018\u0026ndash;1.187) and different postoperative antiplatelet drug strategies (p\u0026thinsp;=\u0026thinsp;0.004, OR\u0026thinsp;=\u0026thinsp;0.187, 95%CI\u0026thinsp;=\u0026thinsp;0.059\u0026ndash;0.594) were risk factors for graft restenosis in patients undergoing CABG. Multivariate risk analysis suggested that different postoperative antiplatelet drug strategies (p\u0026thinsp;=\u0026thinsp;0.014, OR\u0026thinsp;=\u0026thinsp;0.224, 95%CI\u0026thinsp;=\u0026thinsp;0.068\u0026ndash;0.736) were independent risk factors for restenosis after CABG in patients with myocardial bridge, suggesting that the aspirin\u0026thinsp;+\u0026thinsp;tigrel / clopidogrel dual antiplatelet prescription as a protective factor was 1.224 times lower than aspirin alone in preventing platelet bridging restenosis ( Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of bridge patency and restenosis after CABG\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;56)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGraft patency (n\u0026thinsp;=\u0026thinsp;27)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGraft stenosis (n\u0026thinsp;=\u0026thinsp;29)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esex, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (74.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (75.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eage, Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.9\u0026thinsp;\u0026plusmn;\u0026thinsp;8.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.9\u0026thinsp;\u0026plusmn;\u0026thinsp;8.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esymptom, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (34.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esevere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (66.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (65.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (55.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (51.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (58.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (44.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (48.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (41.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.492\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (96.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (93.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.883\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43 (76.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (74.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (79.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (20.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHLP, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35 (62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (58.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (41.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edrug, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.871\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41 (73.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (70.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (75.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDCAC, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75 (50, 80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75 (50, 80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75 (60, 80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECG, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.285\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (40.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (58.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (59.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (41.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLV, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (85, 100.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91 (87.5, 103)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93 (83, 99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLA, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42.5 (38, 50.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (37.5, 49.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 (38, 52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMR, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (85.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (86.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (13.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLVEF, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (59.8, 67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65 (60.5, 67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63 (59, 66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.332\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBV, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLIMA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45 (80.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (81.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (79.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (20.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC-time, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.5 (40, 61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (43.5, 62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54 (36, 60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.522\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA-time, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (17.8, 33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (18.5, 35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (18, 29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eantiplatelet, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eASA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (40.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (72.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDAPT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (59.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (27.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ebetablocker, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (92.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (92.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (93.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003estatins, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (96.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (92.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiltiazem, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (66.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (96.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (37.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (62.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative symptoms, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eimprovement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (82.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(65.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003einvalid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (17.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (34.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u0026bull; HLP:hyperlipidemia; DCAC:Degree of coronary artery compression; ECG: ST changes in preoperative ECG; LV:left ventricular volume; LA:volume of left atrium; LVEF:left ventricular systolic function;MR:Preoperative mitral regurgitation;BV:saphenous vein bypass graft; LIMA:internal mammary artery; SVG:saphenous vein graft; C-time: cardiopulmonary bypass time; B-time:aortic crossclamp time; ASA:Aspirin antiplatelet; DAPT:Dual AntiPlatelet Therapy;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis and multivariate analysis of the influencing factors of vascular patency rate after CABG\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eunivariate analysis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003emultivariate analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esex, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.877\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.328\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.689\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eage, Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.974\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.133\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esymptom, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.928\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.950\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.875\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.760\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.643\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.745\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHLP, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edrug, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.643\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003estenosis, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.988\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECG, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.423\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.866\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLV, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.601\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.992\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.961\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLA, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLVEF, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.497\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.970\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.888\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBridging selection,n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.901\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.600\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC-time, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.990\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA-time, Median (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.601\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.993\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eantiplatelet, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.594\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.736\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003e\u0026bull; HLP:hyperlipidemia; ECG: ST changes in preoperative ECG; LV:left ventricular volume; LA:volume of left atrium; LVEF:left ventricular systolic function; BV:saphenous vein bypass graft; C-time: cardiopulmonary bypass time; B-time:aortic crossclamp time;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe 10-year follow-up results of the two groups by Kaplan-Meier analysis showed that the patency rate of bridging vessels in the DAPT group was higher than that in the ASA group (59.3% vs. 40.7%, p\u0026thinsp;=\u0026thinsp;0.0093). Additionally, 43.4% of the patients in the ASA group developed bridging vascular restenosis in the fourth year, and 52.1% of the patients in the DAPT group still had bridging vascular restenosis in the sixth year (\u003cb\u003eTable\u0026nbsp;5 and Fig.\u0026nbsp;2).\u003c/b\u003e\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eComment\u003c/h2\u003e \u003cp\u003eMBs can be seen in any epicardial artery, but most MBs (70\u0026ndash;98%) involve the left anterior descending branch. Currently, the most popular and effective examination method is coronary angiography, which determines the existence of MBs by identifying \u0026ldquo;milking signs\u0026rdquo;. The reported incidence of MBs is 1.5\u0026ndash;16%, and the detection rate can increase to 40% after intracoronary injection of nitroglycerin \u003csup\u003e\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Although MBs are considered benign, with the gradual deepening of the understanding of MBs, a series of complications caused by MBs have been widely recognized. In recent years, some researchers have considered MBs to be an independent risk factor for coronary atherosclerosis \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. It has been reported that vasospasm caused by MBs may not only be the cause of myocardial ischemia and ventricular fibrillation and cardiac arrest but also lead to myocardial fibrosis, contractile band necrosis, and increased vascular density, which is closely related to myocardial insufficiency, angina pectoris, acute myocardial infarction and malignant arrhythmia \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Biomechanical changes caused by MBs are also the basis of its complications, such as plaque vulnerability, thrombosis, and vasospasm. Prolonged contraction of the MBs caused by delayed ventricular relaxation may damage early congested diastolic blood flow and local coronary artery spasm, which lasts to diastole because the relaxation time of arterial vascular smooth muscle is later than that of diastole, especially tachycardia. This further worsens coronary perfusion, resulting in diastolic blood flow damage with two secondary pathophysiological consequences, which were related to heart rate and the severity and duration of epicardial artery compression \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. A recent study has shown that MBs may increase the risk of atherosclerosis in the proximal LAD of MBs, especially in patients with cardiovascular disease risk factors, including age, male sex, smoking, diabetes, hypertension, hyperlipidemia, and a family history of cardiovascular disease \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. In summary, MBs may lead to significant cardiovascular consequences (MACE, myocardial ischemia), which require continued follow-up and medical intervention.\u003c/p\u003e \u003cp\u003eThe treatment strategy for myocardial bridge remains controversial. Schwarz et al. \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e proposed that β-blockers have negative chronotropic and inotropic effects, making them one of the first choices for MBs drug therapy. MBs drug therapy focuses on alleviating the potential triggers of aggravating MBs and hemodynamic disorders such as hypertension, myocardial hypertrophy, increased heart rate, and abnormal coronary artery contraction. Calcium channel blockers can reduce myocardial ischemia caused by coronary spasms. Vasodilators, such as nitroglycerin and isosorbide dinitrate, may aggravate the reversal of blood flow from the proximal coronary segment to MBs, resulting in local coronary systolic compression, tachycardia, and proximal vasodilation. However, drug therapy does not fundamentally address the environment of MBs. With increasing age, the prolonged contraction of MBs caused by delayed ventricular relaxation may affect early diastolic blood flow filling, thus shortening the diastolic perfusion time. At the same time, it also leads to locally related coronary spasm, which lasts to the diastolic phase, and finally leads to subendocardial ischemia and interventricular septal ischemia, which is caused by intramural blood theft or branching blood theft. Therefore, the symptoms of angina pectoris in patients without coronary revascularization are usually difficult to reduce with drug treatment, and the frequency of angina pectoris gradually increases with age. Long-term ischemia of the endocardium and interventricular septum in patients will further lead to left ventricular relaxation, followed by an increase in left ventricular volume, and finally require further treatment. The main reason for choosing surgery instead of coronary stents is that there are many complications associated with the latter, such as intraoperative perforation, stent rupture, in-stent restenosis, and thrombosis, and the results of long-term follow-up are not ideal \u003csup\u003e\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. MBs increase the incidence of stent restenosis after interventional therapy for proximal atherosclerotic lesions. According to follow-up, interventional therapy had a higher incidence of MACEs in patients with left anterior descending artery MBs with significant proximal stenosis, and the presence of MBs was significantly correlated with MACEs \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Therefore, the results of this study suggest that if there are symptoms of angina pectoris, changes in the S-T segment of the ECG, and the effect of regular drug treatment is poor, surgical treatment should opted for as soon as possible.\u003c/p\u003e \u003cp\u003eSurgical unroofing and CABG have both advantages and disadvantages. Early complications of surgical myotomy include cardiac perforation, ventricular aneurysm formation, and postoperative bleeding. These complications are often serious and endanger the lives of patients. It is generally believed that when depth more than 5 mm or longer than 25 mm, CABG is better than unroofing \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. In this study, the follow-up results of patients in the operation and non-operation groups showed that the improvement rate of angina pectoris in the operation group was significantly higher than that in the non-operation group. The reintervention rate of patients undergoing operation was significantly lower than that in the non-operation group.\u003c/p\u003e \u003cp\u003eSome researchers believe that the target vessels need to be ligated to avoid competitive blood flow \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. In this study, the coronary artery with the myocardial bridge was not ligated or clipped in the CABG operation, and the primary consideration was to reduce perioperative coronary artery injury, bleeding, ventricular perforation, and other serious complications. It can be found from previous literature that although there is a risk of bridging vessel occlusion caused by competitive blood flow inhibition, no severe stenosis or occlusion of bridging vessels was found during an average follow-up of 35 months \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. However, the target vessels in patients with MBs are difficult to block spontaneously. During our follow-up, we found that in some patients with stenosis and occlusion of the bridging vessels, there was no obvious stenosis of the target vessels during ventricular diastole, which meant that competitive blood flow existed for a long time. Therefore, it was found that 50% of the patients had bridge stenosis or occlusion during follow-up. However, what is interesting is that although these patients had serious stenosis or occlusion of the bridging vessels, their subjective clinical symptoms, namely angina pectoris, were significantly better than those before the operation. Current research results cannot explain this phenomenon well.\u003c/p\u003e \u003cp\u003eFrom the follow-up results of ASA versus DAPT in this study, it can be suggested that although there has been competitive blood flow inhibition in patients with MBs after CABG, which leads to bridging vascular stenosis, dual antiplatelet therapy remains an effective antiplatelet strategy to prevent bridging vascular stenosis. Bridging vessel restenosis may not affect the survival outcome of patients after surgery. The authors believe that CABG surgery delayed the negative effect of MBs on the left ventricular myocardium to some extent, and the left ventricular volume did not continue to increase and tended to return to normal volume in the presence of the bridge. Owing to the short follow-up time, no changes in the left ventricular myocardium were observed after stenosis and occlusion of the bridging vessels. The authors speculated that if the follow-up time continues to be prolonged, cardiac function changes and ECG changes may occur later in patients with patency of bridging vessels than in patients with bridging vessel stenosis.\u003c/p\u003e \u003cp\u003eThis study has some limitations. First, it was a single-center retrospective study, and the data may be biased due to the small sample size; thus, prospective, multicenter studies are needed to confirm our conclusions. Second, we did not compare the outcomes of surgical unroofing and CABG because the number of unroofing surgeries was little.\u003c/p\u003e \u003cp\u003eThis study suggests that surgical treatment can be performed safely and effectively in patients with chest pain and isolated LAD coronary artery myocardial bridging.However,patients should be aware of the potential for recurrent chest pain, and continued medical therapy was important.\u003c/p\u003e \u003cp\u003eFigure 1.Among 124 patients with the diagnosis of myocardial bridging,103 with isolated MB received surgical or medical treatment after applying the specified inclusion and exclusion criteria.\u003c/p\u003e \u003cp\u003eFigure 2. The 10-year follow-up results of the two groups by Kaplan-Meier analysis. The patency rate of bridging vessels in the DAPT group was higher than that in the DAPT group (59.3% vs. 40.7%, p\u0026thinsp;=\u0026thinsp;0.0093). Additionally, 43.4% of the patients in the ASA group developed bridging vascular restenosis in the fourth year, and 52.1% of the patients in the DAPT group still had bridging vascular restenosis in the sixth year.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eMB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003emyocardial bridge\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eCABG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003ecoronary artery bypass grafting\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eSCAG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003eSelective coronary arteriography\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003estandard deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003eodds ratios\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003econfidence interval\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eMACEs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003emajor adverse cardiac events\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eDAPT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003edual antiplatelet prescription\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eECG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003eelectrocardiograph\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.52760736196319%\" valign=\"top\"\u003e\n \u003cp\u003eASA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"71.47239263803681%\" valign=\"top\"\u003e\n \u003cp\u003easprin\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":" \u003cp\u003e All experimental protocols were approved by the Ethical Committee of Changhai Hospital affiliated with Naval Medical University. Informed consent has been waived by the Ethical Committee of Changhai Hospital affiliated with Naval Medical University.All data were collected from the database of the Division of Cardiothoracic Surgery under the permission of the Institutional Review Board of Changhai Hospital.This clinical trial was undertaken after receiving patients' consent.And all methods were performed in accordance with relevant guidelins and regulations.\u003c/p\u003e\u003ch2\u003eFunding Statement:\u003c/h2\u003e \u003cp\u003eThe authors do not have any possible conflicts of interest\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eContributions: (I) Conception and design: Boyao Zhang#, Mengwei Tan#, Xingli Fan#, Jie Lu, Guokun Wang, Jiajun Zhang,Lin Han Yangfeng Tang; (II) Administrative support: L Han; (III) Provision of study materials or patients: Boyao Zhang, Mengwei Tan, Xingli Fan; (IV) Collection and assembly of data: Boyao Zhang, Mengwei Tan, Jie Lu; (V) Data analysis and interpretation: Boyao Zhang, Guokun Wang;(VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. The authors do not have any possible conflicts of interest\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eNone\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData is provided within the manuscript or supplementary information files.\u003c/p\u003e\u003ch2\u003eInformed Patient Consent\u003c/h2\u003e\u003cp\u003eAll patients in this study signed informed consent documents.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLee MS, Chen C-H. Myocardial Bridging: An Up-to-Date Review. J Invasive Cardiol. 2015;27(11):521\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGiuseppe Tarantini F, Migliore F, Cademartiri C, Fraccaro S, Iliceto, et al. Left Anterior Descending Artery Myocardial Bridging: A Clinical Approach. J Am Coll Cardiol. 2016;68(25):2887\u0026ndash;99.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFengping Y, Chen Y. A case of sudden death due to myocardial bridging of the left anterior descending coronary artery. Chin Med J (Engl). 2014;127(13):2553.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWen Gao J, Zhang F, Duan S, Guo C, Chen L, Du, et al. Clinical characteristics and factors associated with coronary stenosis proximal to a myocardial bridge: a retrospective study. BMC Cardiovasc Disord. 2020;20(1):371.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGaudino M, Benedetto U, Fremes S, Biondi-Zoccai G, Sedrakyan A, Puskas JD, et al. Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery. N Engl J Med. 2018;378(22):2069\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQuarello E. [How I do\u0026hellip; to assess an abnormality of the great vessels?]. Gynecol Obstet Fertil. 2009;37(4):349\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYoung-Jae Ki., Myocardial bridging presenting as myocardial ischaemia induced cardiac arrest: a case report. BMC Cardiovasc Disord, 2021. 21(1): p. 178.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErdogan HI, Gul EE, Hasan Gok., Gul, Gok H. Relationship between myocardial bridges and arrhythmic complications. J Invasive Cardiol, 2012. 24(11): pp. E300-2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGiuseppe Tarantini F, Migliore F, Cademartiri C, Fraccaro S. Iliceto., Left Anterior Descending Artery Myocardial Bridging: A Clinical Approach. J Am Coll Cardiol, 2016. 68(25): pp. 2887\u0026ndash;2899.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIshikawa YA-FY, Mikami T, Akasaka Y. Toshiharu Ishii., Settlement of Stenotic Site and Enhancement of Risk Factor Load for Atherosclerosis in Left Anterior Descending Coronary Artery by Myocardial Bridge. Arterioscler ThroMBs Vasc Biol, 2018. 38(6): pp. 1407\u0026ndash;1414.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchwarz ER, Klues HG, Dahl Jvom, Klein I, Krebs W, Hanrath P. Functional, angiographic and intracoronary Doppler flow characteristics in symptomatic patients with myocardial bridging: effect of short-term intravenous beta-blocker medication. J Am Coll Cardiol. 1996;27(7):1637\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnwar T, Brian K, Whisenant AD, Michaels. Stent fracture following stenting of a myocardial bridge: report of two cases. Catheter Cardiovasc Interv. 2008;71(2):191\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErnst A, Joško Bulum, Jadranka Šeparović Hanževački, Martina Lovrić Benčić, Strozzi M. Five-year angiographic and clinical follow-up of patients with drug-eluting stent implantation for symptomatic myocardial bridging in absence of coronary atherosclerotic disease. J Invasive Cardiol, 2013. 25(11): pp. 586\u0026thinsp;\u0026ndash;\u0026thinsp;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrabhakar B, Kunamneni S, Rajdev P, Krishnan, Pedro R, Moreno MC, Kim SK, Sharma, Annapoorna S, Kini. Outcome of intracoronary stenting after failed maximal medical therapy in patients with symptomatic myocardial bridge. Catheter Cardiovasc Interv. 2008;71(2):185\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang Hao JX, Ahmed Z, Huanjun P, Zhanqi W, Yanfei W, et al. The Outcome of Percutaneous Coronary Intervention for Significant Atherosclerotic Lesions in Segment Proximal to Myocardial Bridge at Left Anterior Descending Coronary Artery. Int Heart J. 2018;59(3):467\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAttaran S, Moscarelli M, Athanasiou T, Anderson J. Is coronary artery bypass grafting an acceptable alternative to myotomy for the treatment of myocardial bridging? Interact Cardiovasc Thorac Surg. 2013;16(3):347\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZou Y-X, Huang F-J, Wu Q, Zhu E-J. Graft occlusion after coronary artery bypass grafting and stent deformation and in-stent restenosis after succedent stenting in a patient with deep position myocardial bridging. Interact Cardiovasc Thorac Surg. 2012;15(3):537\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu Qing-yu, Xu Zhong-hua. Surgical treatment of myocardial bridging: report of 31 cases. Chin Med J (Engl). 2007;120(19):1689\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang X-H, Wang S-Y, Xu J-P, Song Y-H, Tang H-SSY, et al. Surgical outcome and clinical follow-up in patients with symptomatic myocardial bridging. Chin Med J (Engl). 2007;120(18):1563\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Myocardial bridge (MB), Surgical treatment, Coronary artery bypass grafting (CABG), Unroofing","lastPublishedDoi":"10.21203/rs.3.rs-4180201/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4180201/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThere is a paucity of data regarding surgical results of myocardial bridging(MB).Our study aimed to evaluate the clinical efficacy of surgical treatment including coronary artery bypass grafting (CABG) and unroofing for MB in symptomatic patients who had chest pain refractory to medical therapy..\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAmong 124 adult patients diagnosed with myocardial bridging at our institution(2010\u0026ndash;2019),85 underwent surgical intervention and 39 received medical treatment.To understand the potential benefit of surgical treatment,we excluded 21 patients with concomitant operations for other diagnoses or obstructive coronary disease.64 symptomatic patients with isolated left anterior descending(LAD) MB underwent surgical treatment,which included CABG for 56 patients and unroofing for 8 patients. All patients were followed up 1 to 10 years.We analyzed recurrent symptoms,postoperative medication use,and adverse cardiovascular events.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMean age was 60.9\u0026thinsp;\u0026plusmn;\u0026thinsp;8.4 years(48 men [75%]).All patients underwent preoperative coronary angiography.Mean cardiopulmonary bypass and cross-clamp times were 53.5\u0026thinsp;\u0026plusmn;\u0026thinsp;19.8 minutes and 24.0\u0026thinsp;\u0026plusmn;\u0026thinsp;10.1 minutes,respectively.During follow-up(median, 28 months) there were no cardiac-related deaths.The reintervention rate after discharge in the operation group was lower than that in the non-operation group (14.3% vs. 35.9%, p\u0026thinsp;=\u0026thinsp;0.027). The symptom improvement rate of patients in the operation group was higher than that in the non-operation group (82.8% vs 48.7%, p\u0026thinsp;=\u0026thinsp;0.001). Through multivariate risk analysis, we found that antiplatelet strategies (p\u0026thinsp;=\u0026thinsp;0.004, OR\u0026thinsp;=\u0026thinsp;0.187, 95%CI\u0026thinsp;=\u0026thinsp;0.059\u0026ndash;0.594) were risk factors for graft restenosis in patients with CABG.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eSurgical treatment can be performed safely and effectively in patients with chest pain and isolated LAD coronary artery myocardial bridging.However,patients should be aware of the potential for recurrent chest pain, and continued medical therapy was important.\u003c/p\u003e","manuscriptTitle":"Clinical Outcomes of Surgical Treatment on Myocardial Bridging in Symptomatic Patients Running Title: Surgical treatment outcomes of myocardial bridging","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-08 17:22:12","doi":"10.21203/rs.3.rs-4180201/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"52483555-a0fe-4644-b802-a3dad425b259","owner":[],"postedDate":"April 8th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-19T06:40:27+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-08 17:22:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4180201","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4180201","identity":"rs-4180201","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}