Key result
Uncontrolled hyperlipidemia and diabetes linked to ~200% higher risk of vein graft disease progression.
Why the study?
Predictors of vein graft disease progression between 1 week and 1 year after surgical coronary revascularization and the impact of secondary prevention medications remained to be clarified.
Do secondary prevention medications and clinical factors predict vein graft disease progression within 1 year after surgical coronary revascularization?
Cohort (n=218)
Do secondary prevention medications and clinical factors predict vein graft disease progression within 1 year after surgical coronary revascularization?
Noncontrolled hyperlipidemia, diabetes mellitus, and failure to implement secondary prevention medications are significant predictors of early vein graft disease progression within 1 year after surgical coronary revascularization.
May support intensified secondary prevention after CABG; leaves open whether it reduces early vein graft disease progression.
OBJECTIVE: This study aimed to detect the predictors of vein graft disease (VGD) progression between 1 week and 1 year after surgery and to evaluate the impact of secondary prevention medications. METHODS: A total of 218 consecutive patients underwent surgical coronary revascularization were evaluated by coronary computed tomography angiography both at 1-week and 1-year follow-up. Logistic regression analyses were performed to investigate the predictors of VGD progression. A risk score (0-4) was set up to evaluate implementation result of secondary prevention measures according to 1-year follow-up result. Association between VGD progression and the risk score was assessed. RESULTS: VGD progression occurred in 11.3% of saphenous vein grafts (SVG) and 22.1% of patients. At the patient level, poor vein graft (odds ratio [OR] = 4.25), noncontrolled hyperlipidemia (OR = 3.01), and diabetes mellitus (DM) (OR = 2.96) were predictors, while diameter of SVG (mm, OR = 0.35) was protective factor. At the graft level, DM (OR = 3.52), noncontrolled hyperlipidemia (OR = 2.33), and peripheral artery disease (PAD) (OR = 2.20) were predictors, while number of SVGs (OR = 0.63), diameter of SVG (mm, OR = 0.39), and mean graft flow >25 ml/min (OR = 0.35) were protective factors. VGD progression was significantly associated with the risk score at both the patient (OR = 1.52) and the graft level (OR = 1.38). CONCLUSIONS: Poor vein graft, noncontrolled hyperlipidemia and DM were predictors of VGD progression between 1 week and 1 year after surgery at the patient level, while larger SVG diameter was a protective factor. DM, PAD and noncontrolled hyperlipidemia were predictors at the graft level, while a number of SVGs, larger SVG diameter, and mean graft flow >25 ml/min were protective factors. Implementation failure of secondary prevention medications was associated with VGD progression from as early as 1 year after surgery.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2022) conducted a cohort in Surgical coronary revascularization (n=218). Secondary prevention medications and risk factors was evaluated on Vein graft disease (VGD) progression between 1 week and 1 year. Vein graft disease progression occurred in 22.1% of patients at 1 year, with noncontrolled hyperlipidemia (OR 3.01) and diabetes (OR 2.96) identified as significant patient-level predictors.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: