Relationship Between Vein Graft Failure and Subsequent Clinical Outcomes Following Coronary Artery Bypass Surgery
Background—Vein graft failure (VGF) is common following coronary artery bypass graft (CABG) surgery, but its relationship with long-term clinical outcomes is unknown. In this retrospective analysis, we examined the relationship between VGF, assessed by coronary angiography 12-18 months post-CABG surgery, and subsequent clinical outcomes.
Methods and Results—Using the PREVENT IV trial database, we studied data from 1829 patients who underwent CABG surgery and had an angiogram performed up to 18 months following surgery. The main outcome measure was death, myocardial infarction (MI), and repeat revascularization through 4 years following angiography. VGF occurred in 787 of 1829 patients (43%). Clinical follow-up was completed in 97% of patients with angiographic follow-up. The composite of death, MI, or revascularization occurred more frequently among patients who had any VGF compared with those who had none (adjusted hazard ratio [HR] 1.58, 95% confidence interval [CI] 1.21-2.06; P=0.008). This was due mainly to more frequent revascularization with no differences in death (adjusted HR 1.04, 95% CI 0.71-1.52; P=0.85) or death or MI (adjusted HR 1.08, 95% CI 0.77-1.53; P=0.65).
Conclusions—VGF is common after CABG surgery and is associated with repeat revascularization, but not with death and/or MI. Further investigations are needed to evaluate therapies and strategies for decreasing VGF to improve outcomes in patients undergoing CABG surgery.
- Received April 25, 2011.
- Accepted December 8, 2011.
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