Abstract 13814: Preoperative D-dimer and Haptoglobyn Phenotype Predict Both Venous and Arterial Grafts Occlusion at Mid-term Follow-up. Results From the CoronAry Bypass Grafting: Factors Related to Late Events and Graft patEncy (CAGE) Study
Introduction: graft failure is a common event after coronary artery bypass surgery.
Hypothesis: in this prospective study we assessed the role of clinical variables and of circulating biomarker levels in graft occlusion at mid-term.
Methods: the “CoronAry bypass grafting: factors related to late events and Graft patEncy“ (CAGE) study is an observational study that prospectively enrolled 330 patients undergoing primary elective coronary artery bypass surgery between November 2006 and February 2010 at a single hospital. Blood collection for biomarkers assessment was done before surgery and before hospital discharge. Patients were then scheduled to undergo coronary CT-scan 18 months postoperatively.
Results: one hundred seventy-nine patients underwent coronary CT scan at 18 ± 2 months postoperatively. There were 46/503 (9.1%) occluded grafts at follow-up CT-scan; of these 29 (63%) were venous, whereas 17 (37%) were arterial grafts, respectively; overall, a total of 43 out of 179 (24%) patients had at least one occluded graft. Logistic regression analysis identified D-dimer levels at baseline (OR=3.3, p<0.001), haptoglobin phenotype 1-1 (OR=4.2, p=0.009) and total protein content at discharge (OR=1.18, p=0.02) as independent predictors of overall graft occlusion at follow-up, along with lower body weight. Preoperative D-dimer levels and haptoglobin phenotype 1-1 were also retained as independent predictors in multivariable models that were separately developed for arterial and venous graft occlusions, respectively.
Conclusions: we identified two novel biomarkers that are associated with both arterial and venous graft occlusion. This may help stratify patients at risk of graft failure, and identify new molecular targets to prevent this complication and to improve durability of coronary bypass surgery.
Author Disclosures: A. Parolari: None. L. Cavallotti: None. V. Myasoedova: None. C. Banfi: None. M. Camera: None. D. Andreini: None. F. Alamanni: None. E. Tremoli: None.
- © 2014 by American Heart Association, Inc.