Key result
Diabetes mellitus in CAD patients undergoing CABG was associated with significantly increased saphenous vein graft endothelial damage and U-II immunoreactivity (P<0.001).
Why the study?
To elucidate the effect of DM on the atherosclerotic process in saphenous vein grafts by determining U-II levels in harvested veins of patients undergoing CABG.
Does diabetes mellitus increase urotensin-II immunoreactivity and atherosclerotic damage in saphenous vein grafts of patients undergoing CABG?
Observational (n=21)
Does diabetes mellitus increase urotensin-II immunoreactivity and atherosclerotic damage in saphenous vein grafts of patients undergoing CABG?
Saphenous vein grafts in CAD patients already exhibit atherosclerotic changes prior to grafting, which are more severe in diabetic patients and correlate with increased Urotensin-II immunoreactivity.
DM-associated SVG endothelial damage and U-II elevation may worsen graft outcomes in CABG; leaves open whether U-II targeting improves durability.
OBJECTIVE: To elucidate the effect of diabetes mellitus (DM) on the atherosclerotic process in saphenous vein grafts by determining urotensin-II (U-II) levels in harvested saphenous veins of patients who underwent coronary artery bypass grafting (CABG). METHODS: Coronary artery disease (CAD) patients who underwent CABG were divided into two groups: Group I (eight non-diabetic patients; CAD group) and Group II (13 patients; DM+CAD group). All patients underwent coronary angiography prior to surgery and Gensini score was used to determine the severity of coronary atherosclerosis. Saphenous vein samples were stained with hematoxylin-eosin and U-II, then damage score, H-Score, and vein layer thicknesses were calculated and statistically evaluated. RESULTS: In light microscopic evaluation, significant difference was observed between the groups in terms of endothelial cells damage, internal elastic lamina degradation, and tunica media vascular smooth muscle cells (VSMCs) damage (P<0.001). U-II immunoreactivity was increased in tunica adventitia in the DM+CAD group (P=0.002). The increase in foam cells was directly proportional to the thickening of the subendothelial layer, and this increased U-II immunoreactivity. Gensini score was higher in the DM+CAD group than in the CAD group (P=0.002). CONCLUSION: Our results show that saphenous vein grafts are already atherosclerotic before they are grafted in CAD patients. This disease is more severe in diabetic CAD patients and these changes can be detected using U-II immunoreactivity.
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Tüysüz et al. (2020) conducted an observational in Coronary artery disease (n=21). Diabetes mellitus vs. Non-diabetic CAD patients was evaluated on Endothelial cells damage, internal elastic lamina degradation, and tunica media vascular smooth muscle cells damage (p=<0.001). Diabetes mellitus in CAD patients undergoing CABG was associated with significantly increased saphenous vein graft endothelial damage and U-II immunoreactivity (P<0.001).
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