Identification of risk factors associated with coronary graft occlusion in patients undergoing coronary artery bypass surgery

Abstract

Introduction: Coronary artery bypass graft (CABG) remains the gold-standard approach to patients with severe coronary artery disease (CAD), and the patency of the grafts is one of the main goals of the procedure. This study aims to evaluate the risk factors associated with coronary graft occlusion in patients undergoing this procedure, in order to allow the planning of strategies to minimize the occurrence of this event and its possible consequences to patients. Methods: This is an analytical cross-sectional observational study of secondary data collection, with information provided from medical records of patients undergoing CABG from January 2011 to December 2021, in a high complexity hospital in the South of Brazil. Results: Smoking and the absence of hypertension were significantly associated with graft occlusion (P=0,0016 and P=0,018, respectively), as well as the use of angiotensin-converting enzyme (ACE) inhibitors (P=0.025). Surgical data had no statistically significant association with graft occlusion. For target vessels with critical and complete degrees of stenosis, statistically significant association was observed with the absence of graft occlusion (P<0,001 and P=0,025, respectively). Target vessels with no luminal stenosis were significantly associated with graft occlusion (P<0,001). Left internal thoracic artery (LITA) was significantly associated with the absence of graft occlusion (P<0,001), whereas the use of saphenous vein graft was significantly associated with the presence of graft occlusion (P<0,001). Conclusion: Clinical and epidemiological parameters, the target vessel status and the type of graft are important factors conditioning graft patency.