The Predictive Effects of Clinical Hematological Changes on Saphenous Graft Patency after Coronary Artery Surgery

Abstract

Objectives To investigate the association between clinical hematologic parameters and saphenous vein graft failure after on-pump coronary artery bypass surgery. Methods A total of 1950 consecutive patients underwent isolated on-pump coronary artery surgery between November 2010 and February 2013. Of these, 284 patients met our inclusion criteria; their preoperative clinical hematological parameters were retrospectively obtained for this cohort study. And of them, 109 patients underwent conventional coronary angiography after graft failure was revealed by coronary computed tomography angiography. The primary endpoint was to catch at least one saphenous vein graft stenosis or occlusion following the coronary angiogram. We then analyzed risk factors for graft failure. In sequential or T grafts, each segment was analyzed as a separate graft. Results In logistic regression analysis, older age, platelet distribution width, and diabetes mellitus were identified as independent predictors of saphenous vein graft failure ( P <0.). In contrast, preserved ejection fraction value favored graft patency ( P <0.001). Conclusion Increased platelet distribution width is easily measurable and can be used as a simple and valuable marker in the prediction of saphenous vein graft failure.

Platelet distribution width in young patients with chronic venous insufficiency

“…It has been reported that PDW values increase in some diseases with inflammatory processes and also in several vascular diseases such as coronary artery disease, 6 vasculopathies related to diabetes mellitus, 7 pulmonary arterial hypertension, 8 pulmonary embolism, 9 and saphenous vein graft (SVG) failure. 10 To the best of our knowledge, there has been no research studying PDW values in patients with CVI in the present literature. We hypothesized that PDW values might be significantly affected in patients with CVI when the possible role of platelet activation and inflammatory processes is considered in the etiopathogenesis of CVI.…”

“…Günay et al 9 demonstrated that PDW levels were significantly higher in patients with acute pulmonary embolism than in control subjects. Furthermore, İyigün et al 10 investigated the relationship between CBC parameters and SVG failure in 284 patients undergoing coronary artery bypass surgery. The authors found that the mean PDW level was significantly higher in the SVG occluded group than in the SVG patient group and deduced that PDW could be utilized as a valuable biomarker to predict SVG failure following coronary artery bypass surgery.…”

“…It has been reported that PDW values increase in some diseases with inflammatory processes and also in several vascular diseases such as coronary artery disease, 6 vasculopathies related to diabetes mellitus, 7 pulmonary arterial hypertension, 8 pulmonary embolism, 9 and saphenous vein graft (SVG) failure. 10…”