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Updated: Jun 26, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Evaluation of the Patients with Recurrent Angina After Coronary Artery Bypass Grafting
Salih Salihi1, Halil İbrahim Erkengel2, Fatih Toptan3
1Department of Cardiovascular Surgery, Medicine Faculty, Sakarya University, Sakarya, Turkey.
Insights
Recurrent angina after coronary artery bypass grafting (CABG) can stem from graft or native coronary issues. Early or late recurrence requires careful evaluation and tailored treatment strategies.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
- Recurrent angina post-CABG necessitates understanding underlying causes and effective management.
Purpose of the Study:
- To identify common causes of recurrent angina following CABG.
- To evaluate treatment approaches for patients experiencing recurrent angina after CABG.
Main Methods:
- A retrospective study included patients who underwent CABG between September 2013 and December 2019.
- Patients were categorized into early (within 1 year) and late (after 1 year) recurrent angina groups.
- Data on preoperative characteristics, graft status, and treatment interventions were analyzed.
Main Results:
- No significant differences in preoperative ejection fraction or angiographic findings between early and late recurrence groups.
- Graft failure rates were similar in both groups (27.7% early vs. 26.8% late).
- A higher proportion of early recurrence patients required intervention (46.6%) compared to late recurrence patients (34.1%).
Conclusions:
- Recurrent angina after CABG is often linked to native coronary or graft pathology.
- Prompt diagnosis through coronary angiography is crucial for managing recurrent angina post-CABG.
Introduction:
In this study, we aimed to evaluate the most common causes of recurrent angina after coronary artery bypass grafting (CABG) and our treatment approaches applied in these patients.
Methods:
We included all patients who underwent CABG, with or without percutaneous coronary intervention after CABG, at our hospital from September 2013 to December 2019. Patients were divided into two groups according to the time of onset of anginal pain after CABG. Forty-five patients (58.16 ± 8.78 years) had recurrent angina in the first postoperative year after CABG and were specified as group I (early recurrence). Group II (late recurrence) comprised 82 patients (58.05 ± 8.95 years) with angina after the first year of CABG.
Results:
The mean preoperative left ventricular ejection fraction was 53.22 ± 8.87% in group I, and 54.7 ± 8.58% in group II (P=0.38). No significant difference was registered between groups I and II regarding preoperative angiographic findings (P>0.05). Failed grafts were found in 27.7% (n=28/101) of the grafts in group I as compared to 26.8% (n=51/190) in group II (P>0.05). Twenty-four (53.3%) patients were treated medically in group I, compared with 54 (65.8%) patients in group II (P=0.098). There was a need for intervention in 46.6% (n=21) of group I patients, and in 34.1% (n=28) of group II patients.
Conclusion:
Recurrent angina is a complaint that should not be neglected because most of the patients with recurrent angina are diagnosed with either native coronary or graft pathology in coronary angiography performed.
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