Balla Tímea, Maros Tamás, Csató Gábor, Erdei Nóra, Ványai Beatrix, Nellamkuzhi Noel Johny, Shima Riko, Czuriga Dániel, Csanádi Zoltán, Molnár Andrea, Homoródi Nóra, Kőszegi Zsolt, Kiss Attila, Édes István, Szabó Gábor Tamás
Department of Cardiology and Cardiac Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Geroscience. 2025 May 10. doi: 10.1007/s11357-025-01688-5.
The long-term postoperative occlusion of venous or arterial grafts following coronary artery bypass graft surgery (CABG) is a constant and unresolved problem, with a negative impact on clinical outcome. In our study, we aimed to find predictors that influence graft patency. The data of 202 patients who underwent CABG and had control coronary angiography on an average of 8.55 ± 4.56 years were analyzed retrospectively. Based on the presence of graft occlusion ascertained at control coronary angiography, patients were divided into two groups: 81 in the graft occlusion group (with 89 grafts degeneration: 64 saphenous vein [SVG] and 25 arterial graft) and 121 in the control group with patent grafts. The two groups were considerably well-matched regarding patient characteristics. Among medical conditions, peripheral artery disease has been found to be an independent predictor of increased graft occlusion, but only in SVG patients (OR 3.64, CI 1.21-11.03, p = 0.021). When evaluating medical therapy, significantly more patients were on nebivolol in the control group, compared to the graft occlusion group (p = 0.032). Moreover, nebivolol has been found to be an independent predictor of a lower degree of graft occlusion development (OR 0.36, CI 0.14-0.94, p = 0.036). Nebivolol has been found especially effective in preventing SVG graft occlusion (OR 0.24, CI 0.07-0.76, p = 0.015). Nebivolol has been found to reduce the frequency of graft occlusion following CABG, especially in case of SVG grafts. The vasodilatory properties of nebivolol may, at least in part, be responsible for the favorable effects of the drug to prevent graft occlusion.
冠状动脉旁路移植术（CABG）后静脉或动脉移植物的长期术后闭塞是一个持续存在且尚未解决的问题，对临床结果有负面影响。在我们的研究中，我们旨在寻找影响移植物通畅性的预测因素。对202例行CABG且平均在8.55±4.56年时接受对照冠状动脉造影的患者数据进行回顾性分析。根据对照冠状动脉造影确定的移植物闭塞情况，将患者分为两组：移植物闭塞组81例（89处移植物退变：64处大隐静脉[SVG]和25处动脉移植物），对照组121例，移植物通畅。两组在患者特征方面匹配良好。在医疗状况中，外周动脉疾病已被发现是移植物闭塞增加的独立预测因素，但仅在SVG患者中（OR 3.64，CI 1.21 - 11.03，p = 0.021）。在评估药物治疗时，与移植物闭塞组相比，对照组中使用奈必洛尔的患者明显更多（p = 0.032）。此外，已发现奈必洛尔是移植物闭塞发展程度较低的独立预测因素（OR 0.36，CI 0.14 - 0.94，p = 0.036）。已发现奈必洛尔在预防SVG移植物闭塞方面特别有效（OR 0.24，CI 0.07 - 0.76，p = 0.015）。已发现奈必洛尔可降低CABG后移植物闭塞的发生率，尤其是在SVG移植物的情况下。奈必洛尔的血管舒张特性可能至少部分是该药物预防移植物闭塞的有利作用的原因。
