Impact of Atherogenic Indexes in Saphenous Vein Graft Stenosis

Saphenous vein grafts (SVG) are frequently used in patients that have undergone coronary artery bypass graft (CABG) surgery. Objectives: To evaluate the relationship between atherogenic indexes and SVG stenosis.

Altogether, 534 patients (27.7% women, mean age 65±8.4 years) that underwent CABG and elective coronary angiography were included in the study. Patients with at least one SVG stenosis ≥50% were allocated to the stenosis group SVG (+) (n=259) and patients without stenosis were categorized as SVG (-) (n=275). Atherogenic index of plasma (AIP) and atherogenic coefficient (AC) were calculated from the patients' routine lipid parameters. The level of significance was p<0.05.

The number of patients with a history of hypertension (HT), diabetes mellitus (DM), stroke, and heart failure was significantly higher in the SVG (+) group than in the SVG (-) group. Total cholesterol, triglycerides, LDL-C were significantly higher and HDL-C was lower in the SVG (+) group than in the SVG (-) group. AIP (p<0.001) and AC (p<0.001) were significantly higher in the SVG (+) group than in the SVG (-) group. The receiver operating characteristic (ROC) analysis show that both AIP and AC were better than HDL-C, LDL-C and non-HDL-C at predicting SVG stenosis. In the multivariate analysis, history of DM, HT, stroke, heart failure (HF), number of saphenous grafts, HDL-C, LDL-C, non-HDL-C, AIP and AC were found to be independent risk factors for SVG stenosis.

AIP and AC were independent predictors of SVG stenosis. Moreover, both AIP and AC have better performance in predicting SVG stenosis than LDL-C, HDL-C and non-HDL-C. (Arq Bras Cardiol. 2020; 115(3):538-544).