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HDL Predicts Atherosclerotic Progression in Vein Grafts

Low HDL after CABG associated with atherosclerosis in saphenous vein grafts

FRIDAY, Aug. 24 (HealthDay News) -- In patients with a previous coronary artery bypass graft (CABG) using a saphenous vein graft, predictors of atherosclerosis progression in the graft include low HDL cholesterol and existing atherosclerotic burden, according to study findings published in the Aug. 15 issue of the American Journal of Cardiology.

Josep Rodes-Cabau, M.D., of the Quebec Heart Institute in Laval, Quebec, and colleagues analyzed data on 123 saphenous vein grafts in 86 patients who had undergone CABG and had also had two subsequent cardiac catheterizations a mean of 15 months apart. The researchers measured the burden of atherosclerotic lesions in the vein grafts by dividing each graft into three segments and scoring each segment on a 0-to-3 scale based on presence of lesions, then adding the total.

Forty-eight percent of the patients showed significant angiographic progression in at least one graft between the baseline and follow-up studies. The factors that were independently associated with progression were lower HDL cholesterol (odds ratio 1.38 for each 5 mg/dL decrease in HDL) and a higher atherosclerotic burden score (odds ratio 1.52 for each additional point on the score).

"The present study has shown that in the era of intensive lipid-lowering therapy with the achievement of very low LDL cholesterol levels in most of the patients, low HDL cholesterol level remains an important factor involved in the progression of saphenous vein graft atherosclerosis at midterm follow-up in mild to moderately diseased saphenous vein grafts," the authors write.

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