Principal Findings:

Overall, 733 patients were randomized and underwent surgery. Baseline characteristics were similar between the groups. In the radial artery group, the mean age was 61 years, 96% were men, 42% had diabetes, and mean low-density lipoprotein cholesterol was 104 mg/dl. The target artery was the circumflex in 55%, 53% of patients received three grafts, and on-pump surgery was performed in 89%. In the saphenous vein group, endoscopic vein harvest was used in 20%. Operative mortality was 0.8%.

The primary endpoint, graft patency at 1 year, was 89% for radial artery grafts versus 89% for saphenous vein grafts (p = 0.82). Graft patency was also similar between the groups with the following anastomoses: left anterior descending (83% vs. 85%), circumflex (93% vs. 90%), and right coronary artery (86% vs. 88%). Graft patency was lower among diabetics who received radial artery grafts (p for interaction = 0.04).

High-grade disease (string sign) in the graft was observed in 8% versus 1% (p < 0.001), and 75% to 100% stenosis was observed in 24% versus 16% (p = 0.03), respectively. In the saphenous vein graft group, patency was 78% among those who underwent endoscopic harvesting versus 91% among those who had vein harvesting by other techniques (p = 0.009). Also, in the saphenous vein graft group, patency was 90% among those who underwent on-pump procedures versus 78% among those who had off-pump procedures (p = 0.04).

One-year mortality was 2% in both groups, myocardial infarction was 1% in both groups, and stroke was 2% in both groups.