Background/significance: Coronary artery disease prevention is achieved by controlling risk factors for atherosclerosis.
Purpose: Our objective was to test the impact of these risk factors on saphenous vein graft (SVG) occlusion in patients post coronary artery bypass graft (CABG) surgery.
Methods: We retrospectively studied 1,000 consecutive patients (mean age 66 years, 66% men) who underwent CABG surgery from January 2000 to August 2004 for the presence of SVG occlusion on coronary angiogram. Risk factors including smoking history, dyslipidemia, obesity, hypertension and diabetes mellitus were recorded. Follow-up data were available through October 2011. Wilcoxon rank-sum and chi-square tests were used to analyze data.
Results: Univariate analysis showed statistical difference in SVG occlusion for triglycerides >150 mg/dL, total cholesterol >200 mg/ dL, and high-density lipoprotein (HDL) <40 mg/dL (men) or <50 mg/dL (women). Logistic regression used for multivariate analysis showed SVG occlusion was strongly associated with triglycerides (odds ratio [OR] 2.2, 95% confidence interval [CI], 1.6-3.0, p<0.0001), and HDL (OR 2.3, CI, 1.7-3.1, p<0.0001). Strict control of triglycerides <70 mg/dL resulted in less SVG occlusion.
Conclusion: Uncontrolled triglycerides and high-density lipoprotein levels are the driving variables behind saphenous vein graft occlusion in patients who have undergone surgical myocardial revascularization. Maintaining triglycerides level <70 mg/dL helps to prevent occlusion.