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KMID : 0880520060420030157
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Chonnam Medical Journal
2006 Volume.42 No. 3 p.157 ~ p.162
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Predictive Factors for the Stenosis of Internal Thoracic Artery after Coronary Artery Bypass Graft
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Choi Ok-Ja
Jeong Myung-Ho
Lim Sang-yup
Park Hyung-Wook
Hong Young-Joon
Jeong Seon-Young
Kim Ju-Han
Kim In-Soo
Moon Jae-Youn
Ahn Young-Keun
Cho Jeong-Gwan
Ahn Byung-Hee
Park Jong-Chun
Kang Jung-Chaee
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Abstract
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Compared with standard saphenous vein grafts, internal thoracic artery conduits have an excellent long-term patency rate. Nevertheless, graft stenosis can occur and limit further revascularizaton. We sought to investigate the predictive factors of left internal thoracic artery (LITA) stenosis. Between April 1996 and July 2005, 324 patients (60.8+/-8.7 years, 240 male) underwent a follow-up coronary angiography (CAG) following coronary artery bypass graft. The patients with stenosis in LITA (group I : n=38, 59.1+/-8.5 years, 31 male) were compared with the patients without LITA stenosis (group II : n=286, 60.9+/-8.7 years, 209 male). The baseline clinical characteristics, laboratory findings, such as total cholesterol, C-reactive protein, hemoglobin A1C, fibrinogen, and procedure-related factors were similar between the two groups. Left ventricular ejection fraction was lower in group I at the time of follow-up CAG than in group II (54.3+/-11.0% vs. 59.2+/-12.7%, p<0.05). High density lipoprotein (HDL)-cholesterol levels were lower in group I (39.2+/-9.9 mg/dl vs. 43.7+/-10.5 mg/dl, p<0.05), and triglyceride levels were higher in group I than in group II (152.9+/-98.9 mg/dl vs. 116.9+/-67.5 mg/dl, p<0.05). The stenosis of LITA occurred in 19 cases (5.8%) at 1 month after operation, 2 cases (0.3%) between 1 month and 1 year, 11 cases (3.4%) between 1 and 3 years, and 6 cases (1.9%) at 3 years after operation. In the multivariate analysis, low HDL-cholesterol and high triglyceride were independent predictors for the LITA stenosis. The stenosis of LITA is related with low HDL-cholesterol and high triglyceride.
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KEYWORD
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Coronary artery bypass, Internal thoracic artery, Stenosis
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