Related Experiment Videos
Accelerated progression of atherosclerosis in coronary vessels with minimal lesions that are bypassed
Insights
Coronary artery bypass surgery accelerates atherosclerosis in minimally diseased vessels. Bypassed arteries with less than 50% stenosis showed over 10 times more disease progression than non-bypassed comparable arteries.
Area of Science:
- Cardiovascular Science
- Medical Research
- Surgical Outcomes
Background:
- Accelerated atherosclerosis is documented in bypassed coronary arteries with >50% preoperative stenosis.
- The impact of coronary bypass on vessels with minimal disease (<50% stenosis) requires further investigation.
Purpose of the Study:
- To evaluate the effect of coronary artery bypass surgery on the progression of atherosclerosis in minimally diseased coronary arteries.
Main Methods:
- Study included 85 men who underwent coronary bypass surgery.
- Compared atherosclerosis progression in bypassed (n=37) versus non-bypassed (n=93) coronary arteries with <50% stenosis.
- Follow-up averaged 37 months, defining progression as ≥25% lumen loss.
Main Results:
- Progression of atherosclerosis was significantly more frequent in bypassed arteries with minimal disease (38%) compared to non-bypassed arteries (3%).
- The rate of progression was over 10 times higher in bypassed minimally diseased arteries.
Conclusions:
- Minimally diseased coronary arteries (<50% stenosis) should not be bypassed due to accelerated atherosclerosis progression.
- Coronary bypass surgery may adversely affect the natural course of atherosclerosis in less diseased vessels.
Abstract:
Accelerated progression of atherosclerosis is known to occur in surgically bypassed coronary arteries in which the preoperative stenosis was greater than 50 per cent. To assess the effect of coronary bypass on vessels with lesser degrees of stenosis, we studied 85 men who had undergone coronary bypass surgery. In this group we identified bypass grafts placed in 37 arteries with minimal atherosclerosis, which was defined as less than 50 per cent stenosis of the vessel diameter. In the same 85 men there were 93 coronary vessels with minimal atherosclerosis for which a bypass graft had not been placed. Progression of atherosclerosis, defined as further loss of at least 25 per cent of the lumen, during an average follow-up period of 37 months was more than 10 times as frequent (38 per cent vs. 3 per cent) in bypassed arteries with minimal atherosclerosis as in comparable arteries that were not bypassed. These findings support the view that minimally diseased coronary arteries should not be bypassed.