eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
4/2018
vol. 14
 
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abstract:
Original paper

Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography

Grzegorz M. Kubiak, Magdalena Dobrolińska, Elżbieta Pociask, Wojciech Wańha, Paweł Gąsior, Grzegorz Smolka, Andrzej Ochała, Wojciech Wojakowski, Tomasz Roleder

Adv Interv Cardiol 2018; 14, 4 (54): 363–372
Online publish date: 2018/12/11
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Introduction
Coronary artery bypass grafting (CABG) is a method of choice in treatment of diffuse coronary artery disease (CAD), although it has some limitations such as late saphenous vein graft (SVG) patency loss, which occurs in one fifth of all conduits at 5 years. Since atherosclerosis in SVG has diffuse characteristics, it appears that significantly and non-significantly stenosed lesions may have an equal impact on worse prognosis.

Aim
To assess non-significant lesions of SVG by the use of optical coherence tomography (OCT) and investigate the clinical and laboratory findings with the potential impact on plaque composition.

Material and methods
Twenty-nine patients with 43 non-significant lesions were enrolled in the study. All variables were assessed using uni- and multivariable logistic regression analysis with each plaque morphology as a dependent variable. Odds ratio (OR) and 95% confidence interval (CI) were computed.

Results
Plaque rupture (PRT) was independently associated with age (OR = 1.49, 95% CI: 1.09–2.04, p = 0.015) and lower rates of high-density lipoproteins (HDL) cholesterol (OR = 0.67, 95% CI: 0.49–0.92, p = 0.016). Intimal tearing or rupture (ITR) was related to reduced GFR (OR = 0.52, 95% CI: 0.38–0.72, p = 0.0004). Lipid-rich plaque (LRP) was associated with raised platelet count (PLT) (OR = 1.51, 95% CI: 1.16–1.96, p = 0.004) and increased frequency of smoking (OR = 1.45, 95% CI: 1.12–1.89, p = 0.007).

Conclusions
Atherosclerosis of SVG is not restricted to significantly stenosed lesions. Plaque composition is independently associated with different types of clinical and laboratory findings, mostly recognized as risk factors of CAD.

keywords:

optical coherence tomography, coronary artery disease, saphenous vein graft coronary artery bypass grafting

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