Kosin Med J.  2022 Jun;37(2):140-145. 10.7180/kmj.22.104.

Incidence of arterial steno-occlusive disease and related factors in patients undergoing coronary artery bypass graft surgery

• Kim SG
• Lee GW
• Lee CH

• KMID: 2532044
• DOI: http://doi.org/10.7180/kmj.22.104

Abstract

Background
Patients who undergo coronary artery bypass graft (CABG) surgery receive regular physical examinations and medications on an outpatient basis. However, these patients are at risk of developing other vascular diseases, such as postoperative arterial steno-occlusive disease (SOD). This study investigated the incidence of SOD and related factors.
Methods
In total, 246 patients who underwent CABG surgery from January 1, 2017 to December 31, 2021 were investigated. The incidence and risk factors of vascular disease were analyzed by dividing the included patients into SOD and non-SOD groups. Laboratory tests, medical history, surgical information, and family history were investigated through an electronic chart review.
Results
Data from 193 patients who met the criteria were analyzed. SOD occurred in 19.1% of patients, and the cerebral artery (38%) was the most common artery involved, followed by the peripheral artery (32%), the coronary artery (22%), and the retinal artery (8%). Risk factors for the development of SOD included estimated glomerular filtration rate (eGFR; odds ratio [OR]=0.977, p=0.008), cholesterol (OR=1.020, p=0.001), and patients with diabetes complications (OR=5.077, p=0.010). The 3-year cumulative incidence rate was 21.6%, and the risk factors for cumulative occurrence were a low eGFR, elevated cholesterol, and complications of diabetes.
Conclusions
Low eGFR, high cholesterol, and the presence of diabetic complications before CABG surgery may be associated with postoperative vascular disease. In these cases, close monitoring, proper drug administration, and patient warnings may be required.

Keyword

Coronary artery bypass; Steno-occlusive disease; Vascular disease

Figure

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  Fig. 1. The distribution of involved sites in cases of steno-occlusive disease in our study. Cerebral artery disease and peripheral artery disease had the highest rates (38% and 32%, respectively). Coronary artery disease involving the graft and native vessels occurred in 22% of cases. Retinal artery disease demonstrated the lowest rate (8%).

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  Fig. 2. The cumulative incidence of steno-occlusive disease (SOD) after coronary artery bypass graft (CABG). This figure shows the cumulative incidence of SOD in the study group. The overall 3-year cumulative incidence rate was 21.6%.

Reference

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