Risk Factors Of Saphenous Vein Graft Disease After Coronary Artery Bypass Graft Surgery

[Objective]It is a great burden for patients that the incidence of saphenous vein graft disease(SVGD)after coronary artery bypass graft(CABG)remains high.Thus,this study aims to determine the relative risk factors of SVGD so as to provide a basis for the prevention and treatment of SVGD after CABG.[Methods]Between January 2015 and January 2017,selected patients who underwent isolated CABG and one-year coronary artery computed tomography angiography(CTA)were included in this study.The patients were divided into 2 groups according to the result of CTA,the 'lesioned group' and 'patent group'.Univariate comparative analysis was performed to determine the relationship between SVGD and clinical characteristics.And next,all factors with significant statistical significance(P<0.05)were subjected to multivariate logistic regression analysis to determine whether they were independent risk factors for SVGD.Patients were divided into two subgroups according to whether used cardiopulmonary bypass intraoperatively in order to compare the incidence of SVGD after off-pump and on-pump CABG.[Results]The incidence of SVGD was 16.5%(58/351).Univariate analysis showed that male(43/58;P=0.002),neutrophil to lymphocyte ratio(NLR)(2.74±1.70;P=0.028),high-density lipoprotein cholesterol(HDL)(1.14±0.54;P=0.008),graft free flow(20.26±11.12;P=0.001),pulse index(2.82±0.90;P=0.001),statin therapy(44/58;P=0.006)and non-adherence to the postoperative combination of anti-platelet treatment(APT)(11/58;P =0.037)were related to SVGD.Logistic multivariate regression analyses showed higher NLR(OR=1.238;P=0.013),lower graft free flow(OR=0.96;P=0.030)and higher pulse index(OR=1.364;P=0.042)were independent risk factors.And male(OR=0.429;P=0.032),higher HDL(OR=0.558;P=0.014)and statin therapy(OR=0.406;P=0.036)were protective factors for SVGD.However,non-adherence to the postoperative combination of APT(OR=2.084;P=0.122)was not related to SVGD.Besides,off-pump technique does not reduce the incidence of SVGD.[Conclusion]higher NLR,lower graft free flow and higher pulse index were independent risk factors.Besides,male,higher HDL and statin therapy were protective factors for SVGD.Besides,off-pump technique does not reduce the incidence of SVGD.