Angiographic features of vein grafts versus ungrafted coronary arteries in patients with unstable angina and previous bypass surgery
Objectives. The aim of the study was to compare the angiographic features of culprit coronary lesions located in grafts with those in native coronary arteries in patients with unstable angina and previous coronary artery bypass graft surgery (CABG). Background. Deterioration of angina in patients wi...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1996-11, Vol.28 (6), p.1493-1499 |
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| creator | Chen, Lijia Théroux, Pierre Lespérance, Jacques Shabani, Faryala Thibault, Bernard de Guise, Pierre |
| description | Objectives. The aim of the study was to compare the angiographic features of culprit coronary lesions located in grafts with those in native coronary arteries in patients with unstable angina and previous coronary artery bypass graft surgery (CABG).
Background. Deterioration of angina in patients with previous CABG is usually due to progression of atherosclerosis in coronary arteries or in vein grafts, but the relative importance of graft versus native coronary artery disease as well as the morphologic features of the culprit lesions in unstable angina have not been systematically assessed.
Methods. Disease progression and angiographic features of vein grafts and ungrafted and grafted coronary arteries were assessed in 95 consecutive patients admitted with unstable angina or non-Q wave myocardial infarction with CABG >6 months previously. All patients were receiving aspirin and heparin, and 46 had received streptokinase during the acute phase in a double-blind, placebo-controlled study. Coronary and vein angiography was performed within 8 days after admission (mean [± SD] 5 ± 2 days). The most recent angiogram served to assess disease progression by quantitative angiography.
Results. The culprit lesion was located in a vein graft in 51 patients, an ungrafted coronary artery in 17 and a grafted artery (proximal and distal to the site of graft insertion) in 9 and was of undetermined site in the remaining 18. The proportion of grafts accounting for acute disease increased to 85% with CABG ≥5 years. Total occlusion occurred in 25 vein grafts and 4 ungrafted coronary arteries (49% vs. 24%. p = 0.02). Intravessel thrombus was found in 18 culprit vein grafts but in only 2 ungrafted coronary arteries (37% vs. 12%, p = 0.04). Both intravessel thrombus and total occlusion were demonstrated in six culprit vein grafts but in none of the ungrafted coronary arteries (12% vs. 0%, p = NS). The prevalence of total occlusion and thrombus was not influenced by trial medication, streptokinase or placebo.
Conclusions. Unstable angina in patients with previous CABG is most often due to graft disease and is associated with more frequent thrombi that are more refractory to medical therapy. |
| doi_str_mv | 10.1016/S0735-1097(96)00344-0 |
| format | Article |
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Background. Deterioration of angina in patients with previous CABG is usually due to progression of atherosclerosis in coronary arteries or in vein grafts, but the relative importance of graft versus native coronary artery disease as well as the morphologic features of the culprit lesions in unstable angina have not been systematically assessed.
Methods. Disease progression and angiographic features of vein grafts and ungrafted and grafted coronary arteries were assessed in 95 consecutive patients admitted with unstable angina or non-Q wave myocardial infarction with CABG >6 months previously. All patients were receiving aspirin and heparin, and 46 had received streptokinase during the acute phase in a double-blind, placebo-controlled study. Coronary and vein angiography was performed within 8 days after admission (mean [± SD] 5 ± 2 days). The most recent angiogram served to assess disease progression by quantitative angiography.
Results. The culprit lesion was located in a vein graft in 51 patients, an ungrafted coronary artery in 17 and a grafted artery (proximal and distal to the site of graft insertion) in 9 and was of undetermined site in the remaining 18. The proportion of grafts accounting for acute disease increased to 85% with CABG ≥5 years. Total occlusion occurred in 25 vein grafts and 4 ungrafted coronary arteries (49% vs. 24%. p = 0.02). Intravessel thrombus was found in 18 culprit vein grafts but in only 2 ungrafted coronary arteries (37% vs. 12%, p = 0.04). Both intravessel thrombus and total occlusion were demonstrated in six culprit vein grafts but in none of the ungrafted coronary arteries (12% vs. 0%, p = NS). The prevalence of total occlusion and thrombus was not influenced by trial medication, streptokinase or placebo.
Conclusions. Unstable angina in patients with previous CABG is most often due to graft disease and is associated with more frequent thrombi that are more refractory to medical therapy.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(96)00344-0</identifier><identifier>PMID: 8917263</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Angina, Unstable - diagnostic imaging ; Angina, Unstable - surgery ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - surgery ; Coronary heart disease ; Disease Progression ; Double-Blind Method ; Female ; Graft Occlusion, Vascular - diagnostic imaging ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Phlebography ; Risk Factors</subject><ispartof>Journal of the American College of Cardiology, 1996-11, Vol.28 (6), p.1493-1499</ispartof><rights>1996</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-10365d126a1d2ac98e150b5d7be5d4965e6d9b9a2c3f2e7966fc3ad228866e1b3</citedby><cites>FETCH-LOGICAL-c424t-10365d126a1d2ac98e150b5d7be5d4965e6d9b9a2c3f2e7966fc3ad228866e1b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0735-1097(96)00344-0$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2492066$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8917263$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Lijia</creatorcontrib><creatorcontrib>Théroux, Pierre</creatorcontrib><creatorcontrib>Lespérance, Jacques</creatorcontrib><creatorcontrib>Shabani, Faryala</creatorcontrib><creatorcontrib>Thibault, Bernard</creatorcontrib><creatorcontrib>de Guise, Pierre</creatorcontrib><title>Angiographic features of vein grafts versus ungrafted coronary arteries in patients with unstable angina and previous bypass surgery</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. The aim of the study was to compare the angiographic features of culprit coronary lesions located in grafts with those in native coronary arteries in patients with unstable angina and previous coronary artery bypass graft surgery (CABG).
Background. Deterioration of angina in patients with previous CABG is usually due to progression of atherosclerosis in coronary arteries or in vein grafts, but the relative importance of graft versus native coronary artery disease as well as the morphologic features of the culprit lesions in unstable angina have not been systematically assessed.
Methods. Disease progression and angiographic features of vein grafts and ungrafted and grafted coronary arteries were assessed in 95 consecutive patients admitted with unstable angina or non-Q wave myocardial infarction with CABG >6 months previously. All patients were receiving aspirin and heparin, and 46 had received streptokinase during the acute phase in a double-blind, placebo-controlled study. Coronary and vein angiography was performed within 8 days after admission (mean [± SD] 5 ± 2 days). The most recent angiogram served to assess disease progression by quantitative angiography.
Results. The culprit lesion was located in a vein graft in 51 patients, an ungrafted coronary artery in 17 and a grafted artery (proximal and distal to the site of graft insertion) in 9 and was of undetermined site in the remaining 18. The proportion of grafts accounting for acute disease increased to 85% with CABG ≥5 years. Total occlusion occurred in 25 vein grafts and 4 ungrafted coronary arteries (49% vs. 24%. p = 0.02). Intravessel thrombus was found in 18 culprit vein grafts but in only 2 ungrafted coronary arteries (37% vs. 12%, p = 0.04). Both intravessel thrombus and total occlusion were demonstrated in six culprit vein grafts but in none of the ungrafted coronary arteries (12% vs. 0%, p = NS). The prevalence of total occlusion and thrombus was not influenced by trial medication, streptokinase or placebo.
Conclusions. Unstable angina in patients with previous CABG is most often due to graft disease and is associated with more frequent thrombi that are more refractory to medical therapy.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angina, Unstable - diagnostic imaging</subject><subject>Angina, Unstable - surgery</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Bypass</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary heart disease</subject><subject>Disease Progression</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Graft Occlusion, Vascular - diagnostic imaging</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Phlebography</subject><subject>Risk Factors</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtv1DAQgC0EKkvhJ1TyASE4hNpO7MQnVFW8pEo9FM7WxJ5sjbJJsJOt9s4P7-xDe-U0tuab18fYlRSfpZDm-kHUpS6ksPVHaz4JUVZVIV6wldS6KUpt65dsdUZeszc5_xFCmEbaC3bRWFkrU67Yv5thHcd1gukxet4hzEvCzMeObzEOnBLdnOmd8pL5Mhz-GLgf0zhA2nFIM6ZIFQRPMEccCH-K8yPBeYa2Rw40YQAKgU8Jt3GkTu1ugpx5XtIa0-4te9VBn_HdKV6y39--_rr9Udzdf_95e3NX-EpVMx1SGh2kMiCDAm8blFq0OtQt6lBZo9EE21pQvuwU1taYzpcQlGoaY1C25SX7cOw7pfHvgnl2m5g99j0MSFu5utF7cTWB-gj6NOacsHNTihu610nh9vbdwb7bq3XWuIN9J6ju6jRgaTcYzlUn3ZR_f8pD9tB3CQYf8xlTlVXCGMK-HDEkGduIyWVPZj2GmNDPLozxP4s8A--rpIw</recordid><startdate>19961115</startdate><enddate>19961115</enddate><creator>Chen, Lijia</creator><creator>Théroux, Pierre</creator><creator>Lespérance, Jacques</creator><creator>Shabani, Faryala</creator><creator>Thibault, Bernard</creator><creator>de Guise, Pierre</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19961115</creationdate><title>Angiographic features of vein grafts versus ungrafted coronary arteries in patients with unstable angina and previous bypass surgery</title><author>Chen, Lijia ; Théroux, Pierre ; Lespérance, Jacques ; Shabani, Faryala ; Thibault, Bernard ; de Guise, Pierre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-10365d126a1d2ac98e150b5d7be5d4965e6d9b9a2c3f2e7966fc3ad228866e1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angina, Unstable - diagnostic imaging</topic><topic>Angina, Unstable - surgery</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Bypass</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary heart disease</topic><topic>Disease Progression</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Graft Occlusion, Vascular - diagnostic imaging</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Phlebography</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Lijia</creatorcontrib><creatorcontrib>Théroux, Pierre</creatorcontrib><creatorcontrib>Lespérance, Jacques</creatorcontrib><creatorcontrib>Shabani, Faryala</creatorcontrib><creatorcontrib>Thibault, Bernard</creatorcontrib><creatorcontrib>de Guise, Pierre</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Lijia</au><au>Théroux, Pierre</au><au>Lespérance, Jacques</au><au>Shabani, Faryala</au><au>Thibault, Bernard</au><au>de Guise, Pierre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Angiographic features of vein grafts versus ungrafted coronary arteries in patients with unstable angina and previous bypass surgery</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1996-11-15</date><risdate>1996</risdate><volume>28</volume><issue>6</issue><spage>1493</spage><epage>1499</epage><pages>1493-1499</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. The aim of the study was to compare the angiographic features of culprit coronary lesions located in grafts with those in native coronary arteries in patients with unstable angina and previous coronary artery bypass graft surgery (CABG).
Background. Deterioration of angina in patients with previous CABG is usually due to progression of atherosclerosis in coronary arteries or in vein grafts, but the relative importance of graft versus native coronary artery disease as well as the morphologic features of the culprit lesions in unstable angina have not been systematically assessed.
Methods. Disease progression and angiographic features of vein grafts and ungrafted and grafted coronary arteries were assessed in 95 consecutive patients admitted with unstable angina or non-Q wave myocardial infarction with CABG >6 months previously. All patients were receiving aspirin and heparin, and 46 had received streptokinase during the acute phase in a double-blind, placebo-controlled study. Coronary and vein angiography was performed within 8 days after admission (mean [± SD] 5 ± 2 days). The most recent angiogram served to assess disease progression by quantitative angiography.
Results. The culprit lesion was located in a vein graft in 51 patients, an ungrafted coronary artery in 17 and a grafted artery (proximal and distal to the site of graft insertion) in 9 and was of undetermined site in the remaining 18. The proportion of grafts accounting for acute disease increased to 85% with CABG ≥5 years. Total occlusion occurred in 25 vein grafts and 4 ungrafted coronary arteries (49% vs. 24%. p = 0.02). Intravessel thrombus was found in 18 culprit vein grafts but in only 2 ungrafted coronary arteries (37% vs. 12%, p = 0.04). Both intravessel thrombus and total occlusion were demonstrated in six culprit vein grafts but in none of the ungrafted coronary arteries (12% vs. 0%, p = NS). The prevalence of total occlusion and thrombus was not influenced by trial medication, streptokinase or placebo.
Conclusions. Unstable angina in patients with previous CABG is most often due to graft disease and is associated with more frequent thrombi that are more refractory to medical therapy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8917263</pmid><doi>10.1016/S0735-1097(96)00344-0</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Factors Aged Aged, 80 and over Angina, Unstable - diagnostic imaging Angina, Unstable - surgery Biological and medical sciences Cardiology. Vascular system Coronary Angiography Coronary Artery Bypass Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - surgery Coronary heart disease Disease Progression Double-Blind Method Female Graft Occlusion, Vascular - diagnostic imaging Heart Humans Male Medical sciences Middle Aged Phlebography Risk Factors |
| title | Angiographic features of vein grafts versus ungrafted coronary arteries in patients with unstable angina and previous bypass surgery |
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