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Published on: March 27, 2018
Coronary Angiography Characteristics of Symptomatic Patients with Prior Coronary Artery Bypass Graft: A Descriptive
Xiaolong Ma1, Pengfei Chen1, Yicheng Zhao1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
Patients undergoing medical therapy after coronary artery bypass graft (CABG) surgery often present with occluded grafts and diffuse coronary artery disease. This highlights key characteristics for symptomatic post-CABG patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery bypass graft (CABG) surgery is a common treatment for severe coronary artery disease.
- Recurrent symptoms after CABG necessitate further investigation into graft patency and native coronary artery status.
Purpose of the Study:
- To investigate the coronary angiography characteristics of symptomatic patients with a history of CABG.
- To compare angiographic findings between patients treated with medical therapy (MT) and percutaneous coronary intervention (PCI) post-CABG.
Main Methods:
- A retrospective analysis of 993 symptomatic patients who underwent CABG between 2009 and 2017 at Beijing Anzhen Hospital.
- Patients were categorized into MT (n=351) or PCI (n=642) groups, with clinical and angiographic data analyzed.
Main Results:
- Medical therapy patients were older and had higher rates of chronic lung disease compared to the PCI group.
- Patients in the MT group showed a higher incidence of newly developed lesions in both grafts and native coronary arteries (54.4% vs 58.1%) and a greater prevalence of type C coronary artery disease (80.6% vs 60.1%).
- Diffuse lesions in native coronary arteries were significantly more common in the MT group (49.3% vs 15.0%).
Conclusions:
- Symptomatic patients receiving medical therapy post-CABG frequently exhibit occluded grafts.
- Type C coronary artery disease with diffuse lesions is a characteristic finding in patients managed with medical therapy after CABG.
Objectives:
The target of this study was to explore the coronary angiography characteristics for symptomatic patients with prior coronary artery bypass graft (CABG).
Methods:
Between 2009 and 2017, 993 patients who had undergone CABG but subsequently suffered recurrent symptoms in Beijing Anzhen Hospital were selected for this study and divided into either medical therapy (MT) group (n = 351) or percutaneous coronary intervention (PCI) group (n = 642) based on the treatment. Clinical data were analyzed between two groups.
Results:
Patients in the MT group were older and more likely to have chronic lung disease (6.6% vs 3.4%, P=0.026) while patients in the PCI group were more likely to have prior MI (8.8% vs 17.0%, P < 0.001). In the MT group, 54.4% of patients had newly developed lesions both in the graft and native coronary artery while 58.1% in the PCI group (P=0.003), and in the MT group, 80.6% had type C coronary artery disease while 60.1% in the PCI group (P < 0.001). Patients in the MT group presented higher proportion of diffuse lesions (49.3% vs 15.0%, P < 0.001) in native coronary arteries.
Conclusion:
Patients receiving MT (35.3%) likely had occluded grafts and type C coronary artery disease featuring as diffuse lesions.
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