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Published on: March 27, 2018
Serial angiographic follow-up beyond 10 years after coronary artery bypass grafting
Mizuhiro Arima1, Tatsuji Kanoh, Takeshi Suzuki
1Department of Cardiology, International Goodwill Hospital, Yokohama, Japan. shinzen@beige.ocn.ne.jp
Insights
Long-term coronary artery bypass grafting (CABG) outcomes favor arterial grafts (LITA) over vein grafts (SVG). Cholesterol-lowering therapy may improve SVG patency, enhancing cardiac event-free survival.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Biology
Background:
- Long-term prognosis and angiographic follow-up data for coronary artery bypass grafting (CABG) in Japan beyond 10 years are limited.
- Understanding the long-term performance of different graft types is crucial for patient management.
Purpose of the Study:
- To evaluate the long-term outcomes and graft patency rates in patients who underwent CABG, comparing saphenous vein grafts (SVG) with left internal thoracic artery (LITA) grafts.
- To identify factors influencing graft patency and major adverse cardiac events (MACE).
Main Methods:
- Retrospective analysis of 71 patients who underwent CABG before 1992.
- Comparison of MACE-free rates and graft patency between SVG-only and LITA groups.
- Analysis of factors including ejection fraction and hyperlipidemia on outcomes.
Main Results:
- The LITA group demonstrated a significantly higher MACE-free rate compared to the SVG group (p < 0.05).
- LITA patency was significantly higher than SVG patency (p < 0.05).
- Lower SVG patency was observed in patients with hyperlipidemia, which improved with cholesterol-lowering therapy.
Conclusions:
- Long-term outcomes following CABG are favorable, especially when utilizing arterial grafts like LITA.
- While SVG patency is lower than LITA, patient lipid profiles appear to be a significant factor influencing SVG patency.
- Cholesterol-lowering interventions may enhance SVG patency and improve long-term results.
Background:
The long-term prognosis and serial angiographic follow-up beyond 10 years in patients who underwent coronary artery bypass grafting (CABG) have not been fully studied in Japan.
Methods And Results:
In the present study data from 71 patients who underwent CABG before 1992 were analyzed. Thirty patients had a saphenous vein graft (SVG) only group, and the remaining 41 had a left internal thoracic artery graft to the left anterior descending coronary artery (LITA) group; 6 patients died from malignancy, which was the most common cause of death after CABG. The major adverse cardiac events (MACE) were defined as cardiac death, Q-wave or nonQ-wave myocardial infarction, and congestive heart failure. The MACE-free rate was significantly higher in the LITA group than in the SVG group (p < 0.05). However, among the patients with an ejection fraction < 0.40, there was no significant difference in MACE-free rate between the 2 groups. The LITA patency rate was significantly higher than that for SVG (p < 0.05) and the SVG patency rate was lower in the patients with hyperlipidemia (p < 0.05); cholesterol-lowering therapy improved the SVG patency rate.
Conclusion:
The long-term outcome of CABG was favorable, particularly if using an arterial graft. Although the patency rate was lower for the SVG than LITA, the patient's lipid profile might be an important factor in the SVG patency rate.
