Objective Multiarterial grafting during coronary artery bypass grafting (CABG) has been associated with improved long‐term outcomes, but analyses of short‐term outcomes have been limited by selection bias. We sought to assess this gap using a propensity‐matched dual‐institution cohort. Methods We performed a retrospective study of patients undergoing isolated CABG between 2011 and 2024 at two academic centers. Patients were categorized into single‐arterial and multiarterial grafting groups. We used multivariable logistic regression to identify predictors of multiarterial use. Propensity score matching (1:1, caliper 0.05) was then used to compare short‐term outcomes. A subgroup analysis examined outcomes among high‐ vs. low‐probability patients receiving multiarterial grafting. Results In the unmatched cohort, multiarterial recipients were younger with fewer comorbidities. Predictors of reduced odds of multiarterial grafting included female sex (OR: 0.54, 95% CI: 0.41–0.73, p < 0.0001), Black race (OR: 0.43, 95% CI: 0.19–0.98, p = 0.04), diabetes (OR: 0.56, 95% CI: 0.46–0.69, p < 0.0001), dialysis dependence (OR: 0.35, 95% CI: 0.13–0.91, p = 0.03), low ejection fraction < 40% (OR: 0.58, 95% CI: 0.39–0.88, p = 0.009), and prior myocardial infarction (OR: 0.63, 95% CI: 0.50–0.77, p < 0.0001). After matching (607 pairs), there were no significant differences in mortality, stroke, renal failure, or deep sternal wound infection (DSWI). In our “low‐probability” multiarterial grafting group, we noted longer operative times but no differences in mortality (0.19% vs. 0%, p = 0.11). Conclusions After propensity matching, multiarterial grafting was not associated with worse short‐term outcomes compared to single‐arterial grafting. Disparities in multiarterial grafting by sex and race exist and warrant targeted interventions to ensure equitable delivery.
Kubi et al. (Thu,) studied this question.