Risk factors of ischaemic heart disease and long-term outcome after coronary bypass surgery.
BACKGROUND
To investigate the effect of ischaemic heart disease (IHD) risk factors on the long-term course of patients who undergo coronary artery bypass graft (CABG) surgery, was the aim of our study.


METHODS
We studied a total of 128 people, who were classified into 4 groups. Control Group A consisted of 24 healthy adults, Group B of 23 patients who underwent CABG for 3-vessel disease and had no complications in the first two postoperative years, Group C of 41 patients who were hospitalized for acute myocardial infarction (AMI) during the first or second post-CABG year and Group D of 40 patients who were hospitalized for AMI without previous CABG. All subjects were investigated for IHD risk factors (blood glucose, serum lipids, lipoprotein-a) with concurrent assays of coagulation-fibrinolysis factors (fibrinogen, antithrombin-III, PAI-1 and t-PA).


RESULTS
We found that: 1. Patients with previous CABG represented 50.6% of the total number of patients admitted with AMI in our department during one year. Compared to Groups A (controls) and B (CABG with good course), these patients (Group C) had significant increases in Lp (a), fibrinogen, LDL-ch, PAI-1 and t-PA and decreased HDL-ch and AT-III. 2. There were no significant differences in these factors in patients with AMI, regardless of whether they had had previous CABG.


CONCLUSIONS
It is concluded that the accumulation of IHD risk factors and coagulation-fibrinolysis abnormalities play a significant role in the postoperative course of patients undergoing CABG, regardless of the use of anti-angina medication. It is imperative that such factors be corrected.
Efthimiadis
A
A
Cardiac Unit-Clinic of Lipid Disturbances, 2nd Department of Internal Medicine, Aristotelian University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Lefkos
N
N
Psirropoulos
D
D
Papadopoulos
I
I
Boudonas
G
G
Lefkou
E
E
Efthimiadis
I
I
Tsapas
G
G
D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D001786:Blood Glucose; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D001026:Coronary Artery Bypass; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000209:etiology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012307:Risk Factors; D017741:Survivors; D010959:Tissue Plasminogen Activator / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D017395:Plasminogen Activator Inhibitor 1; D000990:Antithrombin III; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator