Association of lipoprotein(a) excess with early vein graft occlusions in middle-aged men undergoing coronary artery bypass surgery

Pokrovsky, S.; Ezhov, M.; Ilina, L.; Афанасьева, О. И.; Sinitsyn, V. E.; Ширяев, А. А.; Акчурин, Р. С.

doi:10.1016/s0022-5223(03)00365-9

Cited by 22 publications

(10 citation statements)

References 27 publications

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“…Причем у 70-80% пациентов, пере-несших периоперационный ИМ, определяются нефунк-ционирующие шунты [6,13]. Существует много факторов, влияющих на проходимость шунтов и анастомозов, боль-шинство системных факторов риска постоянно изучают-ся [4]. Четко дифференцировать влияние техники опера-ции вряд ли представляется возможным.…”

Section: Discussionunclassified

10-year results of coronary artery bypass grafting with microsurgical technique

Акчурин¹,

Shiryaev²,

Galyautdinov³

et al. 2016

Kardiol. serdechno-sosud. khir.

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Преимущества применения операционных микро-скопов, микрохирургических инструментов и тонкого «микрохирургического» шовного материала для сшива-ния артерий малого калибра давно доказаны в рекон-структивной хирургии [16]. В начале 70-х гг. микрохирур-гическая техника была внедрена для манипуляции на ко-ронарных артериях (КА), однако эта методика не получи-ла распространения, так как требовала переквалифика-ции хирургов. Кроме того, ошибочно принятое в качестве операции выбора, на протяжении 20 лет, только аутове-нозное коронарное шунтирование (КШ) чаще всего не требовало значительного оптического увеличения и ис-пользования микрохирургических методов [10,20]. Более широкое внедрение множественного аутоартериального КШ, использование бимаммарных, Y-образных кон-струкций, желудочно-сальниковых артерий требует по-вышения прецизионности вмешательства, что обусловли-вает перспективность применения методов микрохирур-гии [15]. С 1985 г. в нашей клинике микрохирургическая техника рутинно применяется в коронарной хирургии [1][2][3]. Однако остается открытым вопрос об эффектив-ности применения операционного микроскопа по срав-нению со стандартной техникой выполнения дистальных анастомозов (ДА). Aim. To compare long-term outcomes of coronary artery bypass surgery using microsurgical and standard technique for distal anastomoses. Material and methods. It was analyzed 10-year results of 193 patients who underwent elective coronary artery bypass grafting (CABG) in 1999-2001. Analysis included survival, angina recurrence, incidence of non-fatal myocardial infarction and reoperation rate. Initially patients were randomized into two groups: microsurgical technique (n=89) and conventional technique (n=104). Survival analysis was performed using Kaplan-Meier method. Results. 10-year survival in case of microsurgical method compared with conventional technique was 84,3 and 70,2% (p=0,03); non-fatal myocardial infarction incidence -9,6 and 21,2% (p=0,03); angina recurrence -14,4 and 25,5% (p=ns); reoperation rate -10,8 and 22,3% (p=0,04), respectively. Conclusion. The use of surgical microscope and microsurgical technique decreases mortality, non-fatal myocardial infarction incidence and reoperation rate. Thus, the use of large optical magnification has a positive effect on survival and efficacy of coronary surgery during follow-up. ИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦА 10-year results of coronary artery bypass grafting with microsurgical technique

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Section: Discussionunclassified

10-year results of coronary artery bypass grafting with microsurgical technique

Акчурин¹,

Shiryaev²,

Galyautdinov³

et al. 2016

Kardiol. serdechno-sosud. khir.

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“…Blood LPa concentration >30 mg/dl is associated with rapid atherosclerotic damage to coronary, carotid, peripheral arteries, and autogenous venous bypasses after myocardial revascularization [2,3,10]. At present, there are no medical drugs efficiently decreasing LPa level in human blood, but all LDL apheresis systems can remove LPa due to the presence of apoB 100 in LPa particle.…”

Section: Sorbentmentioning

confidence: 99%

Comparative analysis of efficiency and specificity of various sorbents for apheresis of low-density lipoproteins

et al. 2006

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Efficiency of sorbents for LDL apheresis was compared in vitro. The sorbents based on ion-exchange interaction of the ligand with LDL (Liposorber, DALI) exhibited minimum specificity towards the eliminated component, while immunosorbents (LNP-Lipopak, LDR-TheraSorb) were most efficient. By sorption capacity, the available hemosorbents are inferior to plasmasorbents, which explains low efficiency of the therapy based on single application of hemosorbents especially in patients with consederably increased content of LDL cholesterol.

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“…The primary reason leading to graft occlusion is the development of thrombosis in the early period following surgery, and subsequent intimal hyperplasia that results in graft failure in the first year following implantation. In addition, stenosis generally occurs in grafts during the development of atherosclerosis more than 1 year after the surgery [1].…”

Section: Introductionmentioning

confidence: 99%

Identification of Prognostic Value of Rs3735590 Polymorphism in 3’-Untranslated Region (3’-UTR) of Paraoxonase 1 (PON-1) in Chronic Obstructive Pulmonary Disease Patients who Received Coronary Artery Bypass Grafting (CABG)

Sun

Chen

2018

Cell Physiol Biochem

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Background/Aims: In the treatment of serious and symptomatic coronary heart disease (CHD), coronary artery bypass grafting (CABG) is a frequently utilized intervention. In addition, the risk of CHD is strongly associated with the low activity of paraoxonase-1 (PON1), whose 3’-UTR harbors an rs3735590 polymorphism. The aim of this study was to investigate whether the rs3735590 polymorphism could be used as a prognosis marker in chronic obstructive pulmonary disease (COPD) patients undergoing CABG. In addition, the hypothesis, i.e., the rs3735590 polymorphism may be involved in the regulation of PON1 gene expression via modulating its interaction with miRNAs, was tested in this study. Methods: 292 patients diagnosed with COPD and treated with CABG were recruited for this study. Genomic DNA was extracted from clinical samples, and real-time quantitative PCR and Western-blot were used to measure the expression of miR-616 and PON1 in liver cells of different genotypes. Results: 292 COPD patients were divided into three groups according to their genotypes, i.e., rs3735590: CC (212), TC (75), and TT (5), respectively (TC and TT were merged in one group of T carriers for statistical analyses). Patients with the CC genotype were associated with a shorter event-free survival time as compared to patients with the T genotypes. In addition, PON1 was confirmed as a direct target gene of miR-616, while experiments with primary cells of different genotypes showed that miR-616 inhibited the expression of PON1 in CC cells. On the contrary, rs3735590 impaired such inhibitory effect of miR-616 in TT cells. Conclusion: The rs3735590 polymorphism of PON1 acts as a prognostic biomarker in COPD patients treated by CABG.

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Association of lipoprotein(a) excess with early vein graft occlusions in middle-aged men undergoing coronary artery bypass surgery

Cited by 22 publications

References 27 publications

10-year results of coronary artery bypass grafting with microsurgical technique

10-year results of coronary artery bypass grafting with microsurgical technique

Comparative analysis of efficiency and specificity of various sorbents for apheresis of low-density lipoproteins

Identification of Prognostic Value of Rs3735590 Polymorphism in 3’-Untranslated Region (3’-UTR) of Paraoxonase 1 (PON-1) in Chronic Obstructive Pulmonary Disease Patients who Received Coronary Artery Bypass Grafting (CABG)

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