Depertament of Cardiology, Kartal Kosuyolu High Specialty Training and Research Hospital, University of Medical Sciences, İstanbul, Turkey.
Depertament of Cardiology, Umraniye Training and Research Hospital, University of Medical Sciences, İstanbul, Turkey.
Acta Cardiol. 2021 Sep;76(7):785-791. doi: 10.1080/00015385.2021.1912248. Epub 2021 Apr 21.
Coronary artery bypass grafting (CABG) remains the gold standard treatment for mutivessel and left main coronary artery disease (CAD). Saphenous vein graft (SVG) patency is still a problem in CAD patients after CABG surgery. The Dual Antiplatelet Treatment (DAPT) score is a clinical prediction tool that predicts ischaemic and bleeding risk in CAD patients. The aim of this study is to investigate the relationship between DAPT score and SVG patency in CABG patients.
This retrospective study enrolled a total of 398 patients (68 female; mean age 65.8 ± 9.1 years) with a history of CABG surgery. The study population was divided into two subgroups according to SVG patency. The DAPT score was calculated for each patients and compared between the two groups.
Coronary angiography revealed SVG disease in 212 patients and SVG patency in 186 patients. The rates of diabetes mellitus and hypertension, red cell distribution width values, DAPT Score, time interval after CABG and number of SVGs were significantly higher while LVEF was significantly lower in patients with SVG disease. The presence of diabetes mellitus, high DAPT score, long time interval after CABG and high number of SVGs were found to be independent predictors of SVG patency. DAPT score above 2.5 predicted SVG disease with a sensitivity of 77.1% and a specificity of 87.1% (AUC: 0.873; 95%CI: 0.823-0.924; < 0.001).
The DAPT score may provide useful information for SVG patency in CABG patients. Patients with high DAPT score should be followed up closely for SGV occlusion. DAPT score may be useful prior to CABG in determining the duration of dual anti-platelet therapy and in encouraging the use of arterial grafts with better patency.
冠状动脉旁路移植术（CABG）仍然是多血管和左主干冠状动脉疾病（CAD）的金标准治疗方法。CABG 手术后 CAD 患者的隐静脉移植物（SVG）通畅仍然是一个问题。双联抗血小板治疗（DAPT）评分是一种临床预测工具，可预测 CAD 患者的缺血和出血风险。本研究旨在探讨 DAPT 评分与 CABG 患者 SVG 通畅性之间的关系。
这项回顾性研究共纳入 398 例（68 例女性；平均年龄 65.8±9.1 岁）有 CABG 手术史的患者。根据 SVG 通畅性将研究人群分为两组。计算每位患者的 DAPT 评分，并比较两组之间的评分。
冠状动脉造影显示 212 例患者存在 SVG 病变，186 例患者 SVG 通畅。SVG 病变患者的糖尿病和高血压患病率、红细胞分布宽度值、DAPT 评分、CABG 后时间间隔和 SVG 数量明显较高，而左心室射血分数明显较低。糖尿病、高 DAPT 评分、CABG 后时间间隔长和 SVG 数量多被发现是 SVG 通畅的独立预测因素。DAPT 评分>2.5 预测 SVG 病变的敏感性为 77.1%，特异性为 87.1%（AUC：0.873；95%CI：0.823-0.924；<0.001）。
DAPT 评分可能为 CABG 患者的 SVG 通畅性提供有用信息。DAPT 评分高的患者应密切随访 SVG 闭塞情况。在 CABG 之前，DAPT 评分可能有助于确定双联抗血小板治疗的持续时间，并鼓励使用通畅性更好的动脉移植物。
