The relation of risk factors to the development of atherosclerosis in saphenous-vein bypass grafts and the progression of disease in the native circulation. A study 10 years after aortocoronary bypass surgery
L Campeau, M Enjalbert, J Lesperance, MG Bourassa, P Kwiterovich, S Wacholder, and A Sniderman
We examined 82 patients 10 years after saphenous-vein aortocoronary bypass surgery to determine their angiographic status and to relate those findings to the risk factors for coronary-artery disease. Of 132 grafts shown to be patent 1 year after surgery, only 50 were unaffected at 10 years. The remainder were narrowed (43) or occluded (39). Disease progression in coronary arteries without grafts was also frequent, both in vessels that were normal (15 of 32) and in those with minor stenosis (25 of 53). New lesions did not develop in 15 patients, whereas they did in 67--in the grafts, the native vessels, or both. There was no significant difference between the two groups in the incidence of hypertension, diabetes, or smoking, whereas plasma levels of very-low-density lipoproteins (VLDLs) and low-density lipoproteins (LDLs) were higher, and high-density lipoprotein (HDL) levels were lower in those with new disease than in those without. Univariate analysis showed that plasma cholesterol and triglyceride levels were significantly higher at the time of surgery and at the 10-year examination in those with new lesions. Multivariate analysis indicated that among the lipoprotein indexes, levels of HDL cholesterol and plasma LDL apoprotein B best distinguished the two groups. The findings indicate that atherosclerosis in these patients was a progressive disease, frequently affecting both the grafts and the native vessels, and that the course of such disease may be related to the plasma lipoprotein levels.
This article has been cited by other articles:
van Domburg, R. T., Kappetein, A. P., Bogers, A. J.J.C.
(2008). The clinical outcome after coronary bypass surgery: a 30-year follow-up study. Eur Heart J
0: ehn530v1-6
[Abstract][Full Text]
Hassantash, S.-A., Bikdeli, B., Kalantarian, S., Sadeghian, M., Afshar, H.
(2008). Pathophysiology of Aortocoronary Saphenous Vein Bypass Graft Disease. Asian Cardiovasc. Thorac. Ann.
16: 331-336
[Abstract][Full Text]
Paraskevas, K. I.
(2008). Applications of statins in cardiothoracic surgery: more than just lipid-lowering. Eur. J. Cardiothorac. Surg.
33: 377-390
[Abstract][Full Text]
Suzuki, N., Kozuma, K., Ueno, Y., Nagaoka, K., Kyono, H., Ishikawa, S., Watanabe, H., Yokoyama, N., Takeshita, S., Isshiki, T.
(2008). Serial Quantitative Coronary Analyses for the Evaluation of One-Year Change in Saphenous Vein Grafts. Ann. Thorac. Surg.
85: 525-529
[Abstract][Full Text]
Gongora, E., Sundt, T. M. III
(2008). Myocardial Revascularization with Cardiopulmonary Bypass. Card Surg Adult
3: 599-632
[Full Text]
Hayward, P. A.R., Buxton, B. F.
(2007). Contemporary Coronary Graft Patency: 5-Year Observational Data From a Randomized Trial of Conduits. Ann. Thorac. Surg.
84: 795-799
[Abstract][Full Text]
Rauch, B. H., Scholz, G. A., Baumgartel-Allekotte, D., Censarek, P., Fischer, J. W., Weber, A.-A., Schror, K.
(2007). Cholesterol Enhances Thrombin-Induced Release of Fibroblast Growth Factor-2 in Human Vascular Smooth Muscle Cells. Arterioscler. Thromb. Vasc. Bio.
27: e20-e25
[Abstract][Full Text]
Schepers, A., Eefting, D., Bonta, P.I., Grimbergen, J.M., de Vries, M.R., van Weel, V., de Vries, C.J., Egashira, K., van Bockel, J.H., Quax, P.H.A.
(2006). Anti-MCP-1 Gene Therapy Inhibits Vascular Smooth Muscle Cells Proliferation and Attenuates Vein Graft Thickening Both In Vitro and In Vivo. Arterioscler. Thromb. Vasc. Bio.
26: 2063-2069
[Abstract][Full Text]
Khanderia, U., Townsend, K. A., Eagle, K., Prager, R.
(2005). Statin Initiation Following Coronary Artery Bypass Grafting: Outcome of a Hospital Discharge Protocol. Chest
127: 455-463
[Abstract][Full Text]
Absood, A., Furutani, A., Kawamura, T., Graham, L. M.
(2004). A comparison of oxidized LDL-induced collagen secretion by graft and aortic SMCs: role of PDGF. Am. J. Physiol. Heart Circ. Physiol.
287: H1200-H1206
[Abstract][Full Text]
Canos, D. A., Mintz, G. S., Berzingi, C. O., Apple, S., Kotani, J.-i., Pichard, A. D., Satler, L. F., Suddath, W. O., Waksman, R., Lindsay, J. Jr, Weissman, N. J.
(2004). Clinical, angiographic, and intravascular ultrasound characteristics of early saphenous vein graft failure. J Am Coll Cardiol
44: 53-56
[Abstract][Full Text]
Khurana, R., Shafi, S., Martin, J., Zachary, I.
(2004). Vascular Endothelial Growth Factor Gene Transfer Inhibits Neointimal Macrophage Accumulation in Hypercholesterolemic Rabbits. Arterioscler. Thromb. Vasc. Bio.
24: 1074-1080
[Abstract][Full Text]
Corriere, M. A., Passman, M. A., Guzman, R. J., Dattilo, J. B., Naslund, T. C.
(2004). Mega-Aneurysmal Degeneration of a Saphenous Vein Graft Following Infrainguinal Bypass: A Case Report. VASC ENDOVASCULAR SURG
38: 267-271
[Abstract]
Werba, J. P., Tremoli, E., Massironi, P., Camera, M., Cannata, A., Alamanni, F., Biglioli, P., Parolari, A.
(2003). Statins in coronary bypass surgery: rationale and clinical use. Ann. Thorac. Surg.
76: 2132-2140
[Abstract][Full Text]
Shah, P. J., Gordon, I., Fuller, J., Seevanayagam, S., Rosalion, A., Tatoulis, J., Raman, J. S., Buxton, B. F.
(2003). Factors affecting saphenous vein graft patency: clinical and angiographic study in 1402 symptomatic patients operated on between 1977 and 1999. J. Thorac. Cardiovasc. Surg.
126: 1972-1977
[Abstract][Full Text]
Xu, Q., Zhang, Z., Davison, F., Hu, Y.
(2003). Circulating Progenitor Cells Regenerate Endothelium of Vein Graft Atherosclerosis, Which Is Diminished in ApoE-Deficient Mice. Circ. Res.
93
: e76-e86
[Abstract][Full Text]
Danner, B. C., Horst, M., Ghosh, P. K., Dapunt, O. E.
(2003). Right atrial mass: tumor or aneurysm?. ICVTS
2: 352-354
[Abstract][Full Text]
Akowuah, E. F., Sheridan, P. J., Cooper, G. J., Newman, C.
(2003). Preventing saphenous vein graft failure: does gene therapy have a role?. Ann. Thorac. Surg.
76: 959-966
[Abstract][Full Text]
Enzweiler, C. N.H., Wiese, T. H., Petersein, J., Lembcke, A. E., Borges, A. C., Dohmen, P., Hoffmann, U., Hamm, B.
(2003). Diameter changes of occluded venous coronary artery bypass grafts in electron beam tomography: preliminary findings. Eur. J. Cardiothorac. Surg.
23: 347-353
[Abstract][Full Text]
Woo, Y. J., Gardner, T. J.
(2003). Myocardial Revascularization with Cardiopulmonary Bypass. Card Surg Adult
2: 581-607
[Full Text]
Krejca, M., Skarysz, J., Szmagala, P., Plewka, D., Nowaczyk, G., Plewka, A., Bochenek, A.
(2002). A new outside stent - does it prevent vein graft intimal proliferation?. Eur. J. Cardiothorac. Surg.
22: 898-903
[Abstract][Full Text]
Lardenoye, J.H.P., de Vries, M.R., Lowik, C.W.G.M., Xu, Q., Dhore, C.R., Cleutjens, J.P.M., van Hinsbergh, V.W.M., van Bockel, J.H., Quax, P.H.A.
(2002). Accelerated Atherosclerosis and Calcification in Vein Grafts: A Study in APOE*3 Leiden Transgenic Mice. Circ. Res.
91: 577-584
[Abstract][Full Text]
Hu, Y., Mayr, M., Metzler, B., Erdel, M., Davison, F., Xu, Q.
(2002). Both Donor and Recipient Origins of Smooth Muscle Cells in Vein Graft Atherosclerotic Lesions. Circ. Res.
91
: e13-e20
[Abstract][Full Text]
Shuhaiber, J. H., Evans, A. N., Massad, M. G., Geha, A. S.
(2002). Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. Eur. J. Cardiothorac. Surg.
22: 387-396
[Abstract][Full Text]
Lardenoye, J.H.P., de Vries, M.R., Grimbergen, J.M., Havekes, L.M., Knaapen, M.W.M., Kockx, M.M., van Hinsbergh, V.W.M., van Bockel, J.H., Quax, P.H.A.
(2002). Inhibition of Accelerated Atherosclerosis in Vein Grafts by Placement of External Stent in ApoE*3-Leiden Transgenic Mice. Arterioscler. Thromb. Vasc. Bio.
22: 1433-1438
[Abstract][Full Text]
Absood, A., Furutani, A., Kawamura, T., Graham, L. M.
(2002). Differential PDGF secretion by graft and aortic SMC in response to oxidized LDL. Am. J. Physiol. Heart Circ. Physiol.
283: H725-H732
[Abstract][Full Text]
Guo, L.-r., Steinman, D. A., Moon, B. C., Wan, W.-K., Millsap, R. J.
(2001). Effect of distal graft anastomosis site on retrograde perfusion and flow patterns of native coronary vasculature. Ann. Thorac. Surg.
72: 782-787
[Abstract][Full Text]
Ehsan, A., Mann, M. J., Dell'Acqua, G., Dzau, V. J.
(2001). Long-term stabilization of vein graft wall architecture and prolonged resistance to experimental atherosclerosis after E2F decoy oligonucleotide gene therapy. J. Thorac. Cardiovasc. Surg.
121: 714-722
[Abstract][Full Text]
Drouilhet, J. C. III, Southern, F., Williams, D. K., Brown, A. T., Eidt, J., Moursi, M. M.
(2001). Increased Intimal Hyperplasia After Carotid Endarterectomy in Spontaneously Hypertensive Rats. VASC ENDOVASCULAR SURG
35: 11-18
[Abstract]
Domanski, M. J., Borkowf, C. B., Campeau, L., Knatterud, G. L., White, C., Hoogwerf, B., Rosenberg, Y., Geller, N. L., the Post-CABG Trial Investigators,
(2000). Prognostic factors for atherosclerosis progression in saphenous vein grafts: The postcoronary artery bypass graft (post-CABG) trial. J Am Coll Cardiol
36: 1877-1883
[Abstract][Full Text]
Suda, Y., Takeuchi, Y., Ban, T., Ichikawa, S., Higashita, R.
(2000). Twenty-two-year follow-up of saphenous vein grafts in pediatric Kawasaki disease. Ann. Thorac. Surg.
70: 1706-1708
[Abstract][Full Text]
Dietrich, H., Hu, Y., Zou, Y., Huemer, U., Metzler, B., Li, C., Mayr, M., Xu, Q.
(2000). Rapid Development of Vein Graft Atheroma in ApoE-Deficient Mice. Am. J. Pathol.
157: 659-669
[Abstract][Full Text]
Waters, D. D., Azar, R. R.
(2000). Postscripts From the Post Coronary Artery Bypass Graft Trial : The Sustained Benefit of More Aggressive Cholesterol Lowering and the Enigma of Low-Dose Anticoagulation. Circulation
102: 144-146
[Full Text]
de Feyter, P.J.
(2000). The fatal attraction of saphenous venous bypass grafts. Eur Heart J
21: 697-698
Veldkamp, R.F, Valk, S.D.A, van Domburg, R.T, van Herwerden, L.A, Meeter, K
(2000). Mortality and repeat interventions up until 20 years after aorto-coronary bypass surgery with saphenous vein grafts. A follow-up study of 1041 patients. Eur Heart J
21: 747-753
[Abstract]
Bhargava, B., Kornowski, R., Mehran, R., Kent, K. M., Hong, M. K., Lansky, A. J., Waksman, R., Pichard, A. D., Satler, L. F., Leon, M. B.
(2000). Procedural results and intermediate clinical outcomes after multiple saphenous vein graft stenting. J Am Coll Cardiol
35: 389-397
[Abstract][Full Text]
Peterson, L. R., McKenzie, C. R., Ludbrook, P. A., Sundt, T. M. III, Eichling, J. O., Schardan-Watson, G., Tiefenbrunn, A. J.
(1999). Value of saphenous vein graft markers during subsequent diagnostic cardiac catheterization. Ann. Thorac. Surg.
68: 2263-2266
[Abstract][Full Text]
Webb, J. G., Carere, R. G., Virmani, R., Baim, D., Teirstein, P. S., Whitlow, P., McQueen, C., Kolodgie, F. D., Buller, E., Dodek, A., Mancini, G. B. J., Oesterle, S.
(1999). Retrieval and analysis of particulate debris after saphenous vein graft intervention. J Am Coll Cardiol
34: 468-475
[Abstract][Full Text]
Skinner, J S, Farrer, M, Albers, C J, Neil, H A W, Adams, P C
(1999). High apolipoprotein AI concentrations are associated with lower mortality and myocardial infarction five years after coronary artery bypass graft surgery. Heart
81: 488-494
[Abstract][Full Text]
Favaloro, R. G.
(1998). Landmarks in the Development of Coronary Artery Bypass Surgery. Circulation
98: 466-478
[Full Text]
Wijesinghe, L. D., Ahmed, I. M., Gilbey, S., Berridge, D. C., Scott, D. J. A.
(1998). Implications of Serum Cholesterol Measurement for the Vascular Surgeon. VASC ENDOVASCULAR SURG
32: 241-244
[Abstract]
Motwani, J. G., Topol, E. J.
(1998). Aortocoronary Saphenous Vein Graft Disease : Pathogenesis, Predisposition, and Prevention. Circulation
97: 916-931
[Abstract][Full Text]
Okazaki, J., Komori, K., Kawasaki, K., Eguchi, D., Ishida, M., Sugimachi, K.
(1997). L-Arginine inhibits smooth muscle cell proliferation of vein graft intimal thickness in hypercholesterolemic rabbits. Cardiovasc Res
36: 429-436
[Abstract][Full Text]
Juo, S.-H. H., Beaty, T. H., Kwiterovich, P. O. Jr
(1997). Etiologic Heterogeneity of Hyperapobetalipoproteinemia (HyperapoB) : Results From Segregation Analysis in Families With Premature Coronary Artery Disease. Arterioscler. Thromb. Vasc. Bio.
17: 2729-2736
[Abstract][Full Text]
O'Brien, J. E. Jr., Shi, Y., Fard, A., Bauer, T., Zalewski, A., Mannion, J. D.
(1997). WOUND HEALING AROUND AND WITHIN SAPHENOUS VEIN BYPASS GRAFTS. J. Thorac. Cardiovasc. Surg.
114: 38-45
[Abstract][Full Text]
The Post Coronary Artery Bypass Graft Trial Invest,
(1997). The Effect of Aggressive Lowering of Low-Density Lipoprotein Cholesterol Levels and Low-Dose Anticoagulation on Obstructive Changes in Saphenous-Vein Coronary-Artery Bypass Grafts. NEJM
336: 153-163
[Abstract][Full Text]
Corson, J. D., Mohan, C. R., Hoballah, J. J., Sharp, W. J., Kresowik, T. F.
(1996). Atherosclerosis and Risk Factor Modification: Does It Really Make a Difference?. PERSPECT VASC SURG ENDOVASC THER
9: 75-94
French, J. K., Scott, D. S., Whitlock, R. M.L., Nisbet, H. D., Vedder, M., Kerr, A. R., Smith, W. M.
(1995). Late Outcome After Coronary Artery Bypass Graft Surgery in Patients <40 Years Old. Circulation
92: 14-19
[Abstract][Full Text]
Havel, R. J., Rapaport, E.
(1995). Management of Primary Hyperlipidemia. NEJM
332: 1491-1498
[Full Text]
Klyachkin, M. L., Davies, M. G., Kim, J. H., Barber, L., Dalen, H., Svendsen, E., Hagen, P.-O.
(1994). Postoperative reduction of high serum cholesterol concentrations and experimental vein bypass grafts: Effect on the development of intimal hyperplasia and abnormal vasomotor function. J. Thorac. Cardiovasc. Surg.
108: 556-566
[Abstract][Full Text]
(1994). Collaborative overview of randomised trials of antiplatelet therapy - II: Maintenance of vascular graft or arterial patency by antiplatelet therapy. BMJ
308: 159-168
[Abstract][Full Text]
Mosseri, M., Admon, D., Hasin, Y., Kriwitzki, M., Rosenheck, S., Gotsman, M. S.
(1990). Percutaneous Angioplasty of Totally Occluded Coronary Vein Bypass Grafts: Case Histories. ANGIOLOGY
41: 44-52
[Abstract]
Yao, J.-s., Wang, J.-f., Li, H.-y., Liu, T.-m., Wu Giang, , Duan, W.-z.
(1988). Pathogenesis of Atherosclerosis: I: Role of the Nervous System. ANGIOLOGY
39: 714-719
[Abstract]