D-dimer is associated with arterial and venous coronary artery bypass graft occlusion

Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)200-207.e3
JournalJournal of Thoracic and Cardiovascular Surgery
Volume155
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Coronary Artery Bypass
Transplants
Odds Ratio
Confidence Intervals
Biomarkers
fibrin fragment D
Mammary Arteries
Saphenous Vein
Observational Studies

Keywords

  • coronary artery bypass
  • D-dimer
  • graft patency

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators (2018). D-dimer is associated with arterial and venous coronary artery bypass graft occlusion. Journal of Thoracic and Cardiovascular Surgery, 155(1), 200-207.e3. https://doi.org/10.1016/j.jtcvs.2017.04.043

D-dimer is associated with arterial and venous coronary artery bypass graft occlusion. / 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, 01.01.2018, p. 200-207.e3.

Research output: Contribution to journalArticle

Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators 2018, 'D-dimer is associated with arterial and venous coronary artery bypass graft occlusion', Journal of Thoracic and Cardiovascular Surgery, vol. 155, no. 1, pp. 200-207.e3. https://doi.org/10.1016/j.jtcvs.2017.04.043
Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators. D-dimer is associated with arterial and venous coronary artery bypass graft occlusion. Journal of Thoracic and Cardiovascular Surgery. 2018 Jan 1;155(1):200-207.e3. https://doi.org/10.1016/j.jtcvs.2017.04.043
Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators. / D-dimer is associated with arterial and venous coronary artery bypass graft occlusion. In: Journal of Thoracic and Cardiovascular Surgery. 2018 ; Vol. 155, No. 1. pp. 200-207.e3.
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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.",
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T1 - D-dimer is associated with arterial and venous coronary artery bypass graft occlusion

AU - Coronary Bypass Grafting: Factors Related to Late Events and Graft Patency (CAGE) study investigators

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, Gian Luca

AU - Mussoni, Luciana

AU - Centenaro, Chiara

AU - Alamanni, Francesco

AU - Tremoli, Elena

AU - Zanobini, Marco

AU - Roberto, Maurizio

AU - Porqueddu, Massimo

AU - Naliato, Moreno

AU - Kassem, Samer

AU - Mushtaq, Saima

AU - Bertella, Erika

AU - Pepi, Mauro

AU - Annoni, Andrea

AU - Formenti, Alberto

AU - Brambilla, Marta

AU - Ghilardi, Stefania

AU - Brioschi, Maura

AU - Barbieri, Silvia

PY - 2018/1/1

Y1 - 2018/1/1

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 - coronary artery bypass

KW - D-dimer

KW - graft patency

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