Risk of New Native-Vessel Occlusion After Coronary Artery Bypass Grafting

Sung Han Yoon, Young Hak Kim, Dong Hyun Yang, Jae Hyung Roh, Eun Young Lee, Pil Hyung Lee, Daisuke Sugiyama, Mineok Chang, Jung Min Ahn, Won Jin Choi, Joon Won Kang, Tae Hwan Lim, Joon Bum Kim, Sung Ho Jung, Cheol Hyun Chung, Suk Jung Choo, Jae Won Lee, Soo Jin Kang, Duk Woo Park, Seung Whan LeeCheol Whan Lee, Seong Wook Park, Seung Jung Park

研究成果: Article査読

12 被引用数 (Scopus)


Coronary computed tomography angiography is widely used to evaluate the graft patency, but information on the progression of native-vessel disease remains limited. We sought to evaluate the impact of bypass grafting on native-vessel progression after coronary artery bypass grafting. We evaluated new native-vessel occlusion defined as occlusion length ≥15 mm as a surrogate marker of native-vessel progression. We evaluated 911 patients with 2,271 nonoccluded vessels who underwent coronary artery bypass grafting and received follow-up coronary computed tomography angiography. Over a mean follow-up period of 4.7 years, the new occlusion rates were 9.2% for left anterior descending artery (LAD), and 13.9% for non-LAD, respectively. For non-LAD, new occlusion rate of vessels with bypass grafts was higher compared to those without bypass graft regardless of baseline native-vessel stenosis (intermediate stenosis: 8.6% vs 1.7%, p <0.001; severe stenosis: 20.5% vs 9.9%, p = 0.003). Furthermore, new occlusion rate of vessels with venous graft was the highest, followed by vessels with arterial graft and vessels without bypass graft, regardless of baseline stenosis (intermediate stenosis: 11.1% vs 5.2% vs 1.7%, p <0.001; severe stenosis: 23.7% vs 15.9% vs 9.9%, p <0.001). By multivariate analysis, bypass grafting was associated with new native-vessel occlusion for non-LAD (odds ratio 3.04, 95% confidence interval 1.79 to 5.14; p <0.001). Bypass graft was associated with new native-vessel disease progression regardless of baseline stenosis. In conclusion, the decision to bypass or leave a native vessel with intermediate stenosis should cautiously be considered.

ジャーナルAmerican Journal of Cardiology
出版ステータスPublished - 2017 1月 1

ASJC Scopus subject areas

  • 循環器および心血管医学


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