title: Predictors of aorto-saphenous vein bypass narrowing late after coronary artery bypass grafting.
abstract: The objective of this study was to evaluate the clinical and angiographic factors associated with significant saphenous vein graft (SVG) atherosclerosis progression at mid-term follow-up in a series of unselected coronary patients who had previously received a coronary artery bypass graft (CABG). A total of 123 SVGs from 86 patients who underwent cardiac catheterization twice, 15 +/- 12 months apart, were included in the study. None of the SVGs presented any > or =50% diameter stenosis (DS) lesion or underwent any intervention at baseline. All SVGs were divided into 3 segments and each SVG segment was scored from 0 to 3 depending on the presence of lesions, with percent DS ranging from 0% to 19% (score 0), 20% to 29% (score 1), 30% to 39% (score 2), and > or =40% (score 3). The SVG atherosclerotic burden score (ABS) was calculated by adding the score obtained for each of the 3 SVG segments. Significant progression was defined as > or =10% increase in lesion percent DS or > or =0.6 mm decrease in minimal lumen diameter between baseline and follow-up studies. Mean age of the study population was 66 +/- 9 years, and most of the patients were receiving statin therapy with mean low-density lipoprotein cholesterol of 85 +/- 26 mg/dl. Significant angiographic progression occurred in > or =1 SVG in 41 patients (48%). On multivariate analysis, the variables associated with SVG atherosclerosis progression were SVG ABS (odds ratio [OR], 1.52 for each increase of 1 point in SVG ABS; 95% confidence interval [CI] 1.1 to 2.29) and high-density lipoprotein (HDL) cholesterol (OR 1.38 for each decrease of 5 mg/dl in HDL cholesterol levels, 95% CI 1.09 to 1.85). Twenty-two patients (26%) had a cardiac event at follow-up related to SVG disease progression. The percent DS of the SVG segment at baseline was associated with SVG disease progression leading to a cardiac event (OR 3.67 for each increase of 5% in percent DS, 95% CI 2.11 to 6.38). In conclusion, simple clinical and angiographic variables such as HDL cholesterol, ABS, and lesion severity remain independent predictors of significant SVG atherosclerosis progression in mild to moderately diseased SVGs despite mean low-density lipoprotein levels <90 mg/dl.
authors: Interventional Cardiology Laboratories, Quebec Heart Institute-Laval Hospital, Laval, Quebec, Canada. josep.rodes@crhl.ulaval.ca
authors: Josep
authors: J
authors: Rodés-Cabau
authors: Alvaro
authors: A
authors: Facta
authors: Eric
authors: E
authors: Larose
authors: Robert
authors: R
authors: DeLarochellière
authors: Jean-Pierre
authors: JP
authors: Déry
authors: Can Manh
authors: CM
authors: Nguyen
authors: Louis
authors: L
authors: Roy
authors: Guy
authors: G
authors: Proulx
authors: Onil
authors: O
authors: Gleeton
authors: Gérald
authors: G
authors: Barbeau
authors: Bernard
authors: B
authors: Noël
authors: Jacques
authors: J
authors: Rouleau
authors: Jean-Roch
authors: JR
authors: Boudreault
authors: Olivier F
authors: OF
authors: Bertrand
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D023903:Coronary Restenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL