Abstract
OBJECTIVE: In this observational prospective study, we assessed the role of clinical variables and circulating biomarkers in graft occlusion at 18 months to identify a signature for graft occlusion.
METHODS: A total of 330 patients undergoing primary elective coronary artery bypass grafting were enrolled. Blood collection for biomarker assessment was performed before surgery and discharge. Patients were then scheduled to undergo coronary computed tomography angiography at 18 months follow-up, and 179 patients underwent coronary computed tomography angiography 18 ± 2 months postoperatively.
RESULTS: There were 46 of 503 (9.1%) occluded grafts; of these, 29 (63%) were venous and 17 (37%) were arterial grafts; overall, 43 of 179 patients (24%) had at least 1 occluded graft. Logistic mixed effects model assessing independent factors associated with graft occlusion identified that lower D-dimer levels at baseline (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.36-4.89; P = .00) and total protein content at discharge (OR, 1.09; 95% CI, 1.01-1.19; P = .028) were related to overall graft occlusion at follow-up, along with an arterial graft other than the left internal thoracic artery (OR, 2.92; 95% CI, 1.24-6.9; P = .078); moreover, a venous graft emerged was possibly associated with graft occlusion (OR, 1.51; 95% CI, 0.95-2.39; P = .078). By separately analyzing saphenous vein and arterial grafts, D-dimer levels (OR, 2.67; 95% CI, 1.15-6.2; P = .022 and OR, 2.5; 95% CI, 1.01-7.0; P = .05 for venous and arterial graft, respectively) were still associated with arterial and venous graft occlusion at follow-up.
CONCLUSIONS: We identified D-dimer as a biomarker associated with arterial and venous grafts occlusion. This may help stratify patients at risk of graft failure and identify new molecular targets to prevent this complication.
| Original language | English |
|---|---|
| Pages (from-to) | 200-207.e3 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 155 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2018 |
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D-dimer is associated with arterial and venous coronary artery bypass graft occlusion. / Parolari, Alessandro; Cavallotti, Laura; Andreini, Daniele; Myasoedova, Veronika; Banfi, Cristina; Camera, Marina; Poggio, Paolo; Barili, Fabio; Pontone, GianLuca; Mussoni, Luciana; Centenaro, Chiara; Alamanni, Francesco; Tremoli, Elena; Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 155, No. 1, 01.2018, p. 200-207.e3.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - D-dimer is associated with arterial and venous coronary artery bypass graft occlusion
AU - Parolari, Alessandro
AU - Cavallotti, Laura
AU - Andreini, Daniele
AU - Myasoedova, Veronika
AU - Banfi, Cristina
AU - Camera, Marina
AU - Poggio, Paolo
AU - Barili, Fabio
AU - Pontone, GianLuca
AU - Mussoni, Luciana
AU - Centenaro, Chiara
AU - Alamanni, Francesco
AU - Tremoli, Elena
AU - Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators
N1 - Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - OBJECTIVE: In this observational prospective study, we assessed the role of clinical variables and circulating biomarkers in graft occlusion at 18 months to identify a signature for graft occlusion.METHODS: A total of 330 patients undergoing primary elective coronary artery bypass grafting were enrolled. Blood collection for biomarker assessment was performed before surgery and discharge. Patients were then scheduled to undergo coronary computed tomography angiography at 18 months follow-up, and 179 patients underwent coronary computed tomography angiography 18 ± 2 months postoperatively.RESULTS: There were 46 of 503 (9.1%) occluded grafts; of these, 29 (63%) were venous and 17 (37%) were arterial grafts; overall, 43 of 179 patients (24%) had at least 1 occluded graft. Logistic mixed effects model assessing independent factors associated with graft occlusion identified that lower D-dimer levels at baseline (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.36-4.89; P = .00) and total protein content at discharge (OR, 1.09; 95% CI, 1.01-1.19; P = .028) were related to overall graft occlusion at follow-up, along with an arterial graft other than the left internal thoracic artery (OR, 2.92; 95% CI, 1.24-6.9; P = .078); moreover, a venous graft emerged was possibly associated with graft occlusion (OR, 1.51; 95% CI, 0.95-2.39; P = .078). By separately analyzing saphenous vein and arterial grafts, D-dimer levels (OR, 2.67; 95% CI, 1.15-6.2; P = .022 and OR, 2.5; 95% CI, 1.01-7.0; P = .05 for venous and arterial graft, respectively) were still associated with arterial and venous graft occlusion at follow-up.CONCLUSIONS: We identified D-dimer as a biomarker associated with arterial and venous grafts occlusion. This may help stratify patients at risk of graft failure and identify new molecular targets to prevent this complication.
AB - OBJECTIVE: In this observational prospective study, we assessed the role of clinical variables and circulating biomarkers in graft occlusion at 18 months to identify a signature for graft occlusion.METHODS: A total of 330 patients undergoing primary elective coronary artery bypass grafting were enrolled. Blood collection for biomarker assessment was performed before surgery and discharge. Patients were then scheduled to undergo coronary computed tomography angiography at 18 months follow-up, and 179 patients underwent coronary computed tomography angiography 18 ± 2 months postoperatively.RESULTS: There were 46 of 503 (9.1%) occluded grafts; of these, 29 (63%) were venous and 17 (37%) were arterial grafts; overall, 43 of 179 patients (24%) had at least 1 occluded graft. Logistic mixed effects model assessing independent factors associated with graft occlusion identified that lower D-dimer levels at baseline (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.36-4.89; P = .00) and total protein content at discharge (OR, 1.09; 95% CI, 1.01-1.19; P = .028) were related to overall graft occlusion at follow-up, along with an arterial graft other than the left internal thoracic artery (OR, 2.92; 95% CI, 1.24-6.9; P = .078); moreover, a venous graft emerged was possibly associated with graft occlusion (OR, 1.51; 95% CI, 0.95-2.39; P = .078). By separately analyzing saphenous vein and arterial grafts, D-dimer levels (OR, 2.67; 95% CI, 1.15-6.2; P = .022 and OR, 2.5; 95% CI, 1.01-7.0; P = .05 for venous and arterial graft, respectively) were still associated with arterial and venous graft occlusion at follow-up.CONCLUSIONS: We identified D-dimer as a biomarker associated with arterial and venous grafts occlusion. This may help stratify patients at risk of graft failure and identify new molecular targets to prevent this complication.
KW - Journal Article
U2 - 10.1016/j.jtcvs.2017.04.043
DO - 10.1016/j.jtcvs.2017.04.043
M3 - Article
C2 - 28549694
VL - 155
SP - 200-207.e3
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 1
ER -