Abstract | BACKGROUND: METHODS AND RESULTS: We performed a post hoc analysis of the Clopidogrel After Surgery for Coronary Artery Disease (CASCADE) trial, where 322 grafts were assessed by angiography and 90 grafts were examined by intravascular ultrasound at 1 year after CABG. We assessed the following correlates for intimal hyperplasia and occlusion: patient characteristics, discharge medications, target vessel characteristics, and SVG diameter. At 1 year, the SVG mean intimal area was 4.3 ± 2.1 mm(2), and the occlusion rate was 6.2% (13/209). Independent correlates of hyperplasia were larger SVG diameter (1.9 ± 0.2 mm(2)/mm; P<0.001), hypertension (0.7 ± 0.3 mm(2); P=0.03), and grafting to the right coronary territory (0.6 ± 0.3 mm(2); P=0.03), whereas statin (-0.8 ± 0.3 mm(2); P=0.01) and β-blocker use (-1.0 ± 0.4 mm(2); P=0.03) were associated with less hyperplasia. Low target vessel quality was an independent correlate of SVG occlusion (odds ratio, 5.2 ± 3.1; P<0.01). CONCLUSIONS:
Hypertension, SVG diameter, grafting to the right coronary artery, and low quality of the target vessel correlate with the development of SVG hyperplasia or occlusion by 1 year after CABG, whereas β-blockers and statins are associated with less SVG disease. These new findings further our understanding of SVG remodeling after bypass surgery and may guide future research to help prevent post-CABG SVG disease. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00228423.
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Authors | Dai Une, Alexander Kulik, Pierre Voisine, Michel Le May, Marc Ruel |
Journal | Circulation
(Circulation)
Vol. 128
Issue 11 Suppl 1
Pg. S213-8
(Sep 10 2013)
ISSN: 1524-4539 [Electronic] United States |
PMID | 24030409
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Clopidogrel
- Coronary Artery Bypass
(adverse effects, trends)
- Double-Blind Method
- Female
- Follow-Up Studies
- Graft Occlusion, Vascular
(diagnosis, drug therapy)
- Humans
- Hyperplasia
(diagnosis, drug therapy)
- Male
- Middle Aged
- Prospective Studies
- Saphenous Vein
(pathology, surgery)
- Ticlopidine
(analogs & derivatives, therapeutic use)
- Time Factors
- Treatment Outcome
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