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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

Renal dysfunction increases the risk of saphenous vein graft occlusion: results from the Post-CABG trial

Gregory A Wellenius1, Kenneth J Mukamal, Wolfgang C Winkelmayer

  • 1Cardiovascular Epidemiology Research Unit, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Deaconess 306, Boston, MA 02215, USA. gwelleni@bidmc.harvard.edu

Atherosclerosis
|August 15, 2006
PubMed

Insights

Chronic kidney disease (CKD) may increase the risk of saphenous vein graft occlusion after coronary artery bypass graft (CABG) surgery. This risk appears related to plaque disruption, not atherosclerotic progression.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Vascular Surgery

Background:

  • Saphenous vein grafts are frequently used in coronary artery bypass grafting (CABG).
  • Chronic kidney disease (CKD) is a known cardiovascular risk factor.
  • The impact of CKD on saphenous vein graft disease is not well understood.

Purpose of the Study:

  • To evaluate the association between chronic kidney disease (CKD) and the progression of disease in saphenous vein grafts post-coronary artery bypass graft (CABG) surgery.
  • To investigate whether CKD influences graft occlusion, lumen diameter changes, or clinical events.

Main Methods:

  • Analysis of data from the Post-CABG Trial involving 1351 patients undergoing CABG surgery.
  • Patients were stratified by baseline estimated glomerular filtration rate (eGFR).
  • Coronary angiography assessed graft disease progression, occlusion, lumen diameter, and clinical events over a median follow-up of 4.2 years.

Main Results:

  • A decreasing eGFR was significantly associated with an increased risk of graft occlusion (P(trend)=0.040).
  • No significant association was found between decreasing eGFR and atherosclerotic progression (P(trend)=0.30), lumen diameter changes (P(trend)=0.067), or recurrent clinical events (P(trend)=0.86).
  • CKD did not significantly modify treatment effects.

Conclusions:

  • Chronic kidney disease (CKD) may be linked to a higher risk of atherosclerotic plaque disruption in saphenous vein grafts.
  • The findings suggest CKD's role in graft disease may involve instability rather than gradual narrowing.
Abstract

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