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Published on: September 10, 2018
CD68 expression in aortocoronary saphenous vein bypass grafts
Agnieszka Malinska1, Bartlomiej Perek, Piotr Buczkowski
1Research and Development Center, Provincial Specialized Hospital in Wroclaw, Wroclaw, Poland. amalinsk@ump.edu.pl
Insights
Macrophages expressing CD68 in saphenous vein grafts may indicate early graft occlusion in patients undergoing coronary artery bypass grafting. This finding could help predict graft stenosis in older adults.
Area of Science:
- Cardiovascular Surgery
- Vascular Biology
- Immunohistochemistry
Background:
- Atherosclerosis impacts older patients undergoing coronary artery bypass grafting (CABG).
- Saphenous vein grafts (SVGs) show better patency in older individuals.
- Macrophage infiltration is an early event in SVG atherosclerosis, but mechanisms are unclear.
Purpose of the Study:
- To assess CD68-positive cells in SVG walls.
- To correlate CD68 infiltration with clinical parameters and graft patency in CABG patients.
Main Methods:
- 309 patients were divided into two age groups (50-70 and >70 years).
- Immunohistochemistry was used to evaluate CD68 expression in SVG tissues.
- Clinical data and graft patency were analyzed.
Main Results:
- No significant difference in CD68 expression between age groups in analyzed vascular regions.
- CD68-positive cells were absent in the tunica intima unless also present in media/adventitia.
- Patients with CD68-positive cells in the intima showed significantly more bypass stenoses.
Conclusions:
- CD68-positive cells in the SVG intima may be an early indicator of graft occlusion.
- This finding could aid in predicting SVG stenosis in CABG patients.
Abstract:
Atherosclerosis commonly affects the arteries harvested from patients 70 years of age or older. Saphenous vein grafts appear to maintain a higher patency rate after coronary artery bypass grafting in these subjects. The infiltration of macrophages is an early step in saphenous vein graft atherosclerosis; however, little is known regarding the underlying mechanisms of infiltration. The objective of the present report is to evaluate the presence of CD68-positive cells in the saphenous vein wall and correlate initial CD68-positive infiltration to specific clinical and biochemical parameters and the graft patency rate as estimated in patients undergoing coronary artery bypass grafting. A total of 309 patients were allocated into two groups: A1 patients, who were between 50 and 70 years of age, and A2 patients, who were 70 years or older at the time of vein harvesting. CD68 expression was evaluated by immunohistochemistry. There were no significant differences between A1 and A2 patients regarding macrophage expression within any of the analyzed vascular regions. Saphenous vein macrophages were never present in the tunica intima unless they were also expressed in the media or the adventitia. The patients with CD68-positive cells in the tunica intima had a significantly higher number of bypass stenoses when compared with the subjects who did not have CD68-positive cells in this layer. These findings suggest that the CD68-positive cells (those that have not yet developed into foam cells) present in the intima of saphenous vein grafts might serve as a very early marker of graft occlusion.
