Risk factors affecting graft stenosis and occlusion after coronary artery bypass graft surgery / 대한내과학회지

ABSTRACT

BACKGROUND: Coronary artery bypass graft (CABG) surgery has been a main treatment modality of ischemic heart disease since Sabiston reported the first CABG operation using a saphenous vein graft in 1963. However, graft stenosis that happens after CABG surgery is one of the main limitations of the procedure. We investigated risk factors that are related to graft stenosis and occlusion in patients that needed a coronary angiogram after CABG surgery. METHODS: From May 1995 to April 2004, we performed 348 CABG surgeries. Among them, we performed follow up coronary angiogram for 45 patients because of clinical indications, corresponding to 146 graft vessels. According to the angiography findings, patients with 27 graft vessels that showed stenosis or occlusion were defined as group S and patients with 119 graft vessels that showed no stenosis or occlusion were defined as group P. RESULTS: The mean patient age of group S is 59.44 (+/-8.549) years and the mean patient age of group P is 57.99 (+/-8.676) years. Group P patients had more stenotic native coronary arteries than group S patients, which is statistically significant (80.0+/-7.2% vs. 68.0+/-11.9%, p=0.005). Group S patients had a statistically significant lower postoperative HDL level than the level of the group P patients (40.4+/-15.9 mg/dL vs. 50.5+/-4.4 mg/dL, p=0.002). CONCLUSIONS: When performing CABG surgery and postoperative patient management, the severity of native coronary artery stenosis and the postoperative HDL level should be considered for better patient outcome.