Preoperative and operative predictive variables of late clinical events following saphenous vein coronary artery bypass graft surgery.
Prediction of late clinical events was studied in a series of 145 patients who had control angiographic studies at one year and between two and 14 years after saphenous vein coronary artery bypass graft surgery. During a mean observation interval of 7.4 years, new narrowing or occlusion occurred in grafts of 59% of the patients and progression in non-bypassed arteries was observed in 66%. One or several of the following events were observed in 56% of the patients: recurrent or worse effort angina, unstable angina, myocardial infarction and heart failure. Unstable angina during follow-up was more frequent in young patients and in those who had this clinical presentation before surgery. The incidence of myocardial infarction was likewise greater in patients who had preoperative unstable angina and in those with four to five risk factors for coronary artery disease, as well as those having a lesser number of inserted grafts. Heart failure was predicted independently by either four to five risk factors, a low left ventricular contraction score or fewer grafts placed at surgery. The number of inserted grafts correlated inversely with any one of the late clinical events.
Lambert
M
M
Montreal Heart Institute, Quebec.
Kouz
S
S
Campeau
L
L
D000328:Adult; D000789:Angina, Unstable / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery