Abstract 1720: Disease Progression in the Non-intervened Saphenous Vein Graft Segments: Serial Intravascular Ultrasound Analysis
We assessed serial (baseline and follow-up) intravascular ultrasound (IVUS) findings in 50 non-intervened saphenous vein graft (SVG) segments in 44 patients (34 males and 10 females) to assess SVG disease progression. The same anatomic image slice was analyzed at baseline and at follow-up; it was located at the follow-up minimum lumen area (MLA) site.
Results: SVG age was 13.5±3.6 years, and follow-up duration was 16.2±7.4 months. Overall, from baseline to follow-up, plaque area increased (Δ=+0.58±1.25 mm2, p=0.003), and SVG and lumen area decreased (Δ=−0.50±1.14 mm2, p=0.002, and Δ=−1.08±1.28 mm2, p<0.001, respectively). Lesions with a decrease in MLA at follow-up were associated with larger baseline SVG and plaque areas and plaque burden and with greater decreases in SVG area and greater increases in plaque area during follow-up (Table⇓). Δlumen area correlated with both Δplaque area (r=−0.589, p<0.001) and ΔSVG area (r=0.470, p=0.001), and Δplaque area correlated with ΔSVG area (r=0.436, p=0.002). There were linear relations between both Δplaque area (r=0.519, p<0.001) and Δlumen area (r=−0.454, p=0.002) versus LDL-cholesterol. Using regression analysis, the cut-off value of LDL-cholesterol for no plaque area increase was 100 mg/dl.
Conclusions: Lumen loss in non-intervened SVG segments is associated with an increase in plaque area and a decrease in SVG area (plaque growth and negative remodeling). Importantly, there was a linear relationship between LDL-cholesterol and plaque growth leading to long-term lumen loss.