Original articleAdult cardiacImpact of Extracardiac Vascular Disease on Vein Graft Failure and Outcomes After Coronary Artery Bypass Surgery
Section snippets
Study Population
We conducted a retrospective analysis using data from the Project of Ex-vivo Vein Graft Engineering via Transfection IV (PREVENT IV) trial database. The design, primary results, and long-term follow-up have been published previously 2, 8, 9. In short, PREVENT IV was a phase 3, multicenter, randomized, double-blind, placebo-controlled trial of ex vivo treatment of vein grafts with the E2F transcription factor decoy edifoligide in patients undergoing CABG surgery. The trial enrolled 3,014
Demographic and Operative Characteristics
Baseline demographic and operative characteristics are described by ECVD status in Table 1. ECVD at baseline was identified in 634 (21.0%) of patients. Among patients with ECVD, 382 (60.3%) had CBVD, 369 (58.2%) had PVD, and 117 (18.5%) both. Patients with ECVD were older, more frequently female, and had a lower body mass index and more comorbidities. Marked differences in operative characteristics were also observed. Use of the internal thoracic artery as a bypass graft was significantly lower
Comment
In this study we investigated the association between ECVD and both vein graft patency and 5-year clinical outcomes after CABG surgery. We found that, compared with patients who did not have ECVD, patients with ECVD were older and had higher rates of comorbidities. These characteristics have probably influenced the intraoperative parameters as well, as suggested by lower use of internal thoracic artery grafting and poorer vein graft quality. After adjustment for these baseline differences, ECVD
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Cited by (12)
Is Peripheral Artery Disease an Independent Predictor of Isolated Coronary Artery Bypass Outcome?
2020, Heart Lung and CirculationCitation Excerpt :In our experience, patients with PAD had comparable estimated mortality rate (p=0.06) with those without PAD. This is in accordance with data [4,19,20] reporting that PAD is an independent risk factor only for late but not early mortality [17,19]. Nonetheless, the mortality rate in PAD increased significantly when LCOS occurred or when CPB and CC times were prolonged.
Prognostic implications of peripheral artery disease in coronary artery disease
2018, Current Opinion in PharmacologyCitation Excerpt :Conversely, patients with CAD and concomitant PAD undergoing CABG surgery, compared to those without PAD, seem to have an increased mid-term and long-term (5–9 years) risk of death (HR1.7; 95% CI 1.2–2.4; p = 0.004) [30]. This excess of risk derives from patients with LEAD, however, there does not seem to be a causal correlation, and this may rather represent a surrogate marker of severe systemic atherosclerotic burden [30,31,33]. Long-term survival after CABG is also influenced by ethnicity, with African-American patients with CAD and concomitant PAD showing a greater risk of death compared to Caucasian patients [34].
About the impact of extracardiac vascular disease on vein graft failure
2014, Annals of Thoracic SurgeryReply
2014, Annals of Thoracic SurgeryNon-coronary atherosclerosis: a marker of poor prognosis in patients undergoing coronary artery bypass surgery
2024, Frontiers in Cardiovascular Medicine