The roles of CHA2DS2-VASc score and blood inflammatory parameters in predicting the patency of saphenous vein grafts in patients with coronary artery bypass graft surgery

Objective: Coronary artery bypass graft (CABG) surgery is a common treatment method in which saphenous vein grafts (SVG) and arterial grafts are used together in severe coronary artery disease. The CHA2DS2-VASc score is used to predict thromboembolic events in nonvalvular atrial fibrillation as well as to predict prognosis in cardiovascular events. In this study, we planned to research the relation between CHA2DS2-VASc score and postoperative SVG patency rates in patients undergoing CABG. Materials and Methods: One hundred seventeen patients with angina after CABG surgery who underwent coronary angiography were analyzed retrospectively. Stenosis of 50% or more in at least one saphenous vein graft was accepted as saphenous vein graft disease (SVGD). We compared these patients in two groups concerning the presence of 50% or more stenosis in the SVG. These two groups were; Group 1 (n = 66); with saphenous vein graft disease, Group 2 (n = 51) without saphenous vein graft disease, respectively. Results: A total of 117 patients participating in the study. Sixty-six patients in group 1 had SVGD (Mean age: 68,13±8,22, 60,6% male). Fifty-one patients in group 2 did not have SVGD (Mean age: 66,92±9,44, 72,5% male ). The mean CHA2DS2-VASc score was significantly higher in group 1 compared to group 2. [5 (2-7) vs. 2 (1-7), respectively, P<0,001]. As a result of multivariate analysis, CHA2DS2-VASc score (OR: 5,263, CI 95%: 2,176- 12,728, P<0.001) and SII (OR: 1,236, CI 95%: 1,120-2,955, P=0.007) were determined as independent predictors for predicting SVGD Conclusion: In the light of the results we have found, the CHA2DS2-VASc score and SII, which are easy to calculate in daily practice, can help us in predicting SVGD.

C-Reactive Protein to Albumin Ratio in Patients With Saphenous Vein Graft Disease

Atherosclerosis plays an important role in saphenous vein graft disease (SVGD). Previous studies showed that inflammatory blood cells play an active role in this process. C-reactive protein to albumin ratio (CAR) is considered as a novel predictor for cardiovascular risk and an indicator of inflammation. We aimed to assess the relationship between SVGD and CAR. A total of 711 participants with saphenous vein graft (SVG) were included; 348 patients had SVGD and 363 patients had patent (no stenosis) SVG. C-reactive protein to albumin ratio was higher in patients with SVGD ( P < .001). There was a significant positive correlation between CAR and the age of SVG (r = 0.123; P = .001) and SYNTAX score (r = 0.568; P < .001). Multivariate logistic regression analyses showed that lymphocyte count, CAR, and SYNTAX score were independent predictors of SVGD ( P < .05). C-reactive protein to albumin ratio may be a useful marker after bypass surgery to predict SVGD.

The Anti-Inflammatory Effects of Anacardic Acid on a TNF-α - Induced Human Saphenous Vein Endothelial Cell Culture Model

Background and Objective: Coronary bypass operations are commonly performed for the treatment of ischemic heart diseases. Coronary artery bypass surgery with autologous human saphenous vein maintains its importance as a commonly used therapy for advanced atherosclerosis. Vascular inflammation-related intimal hyperplasia and atherosclerotic progress have major roles in the pathogenesis of saphenous vein graft disease. Methods: In our study, we investigated the effect of anacardic acid (AA), which is a bioactive phytochemical in the shell of Anacardium occidentale, on atherosclerosis considering its inhibitory effect on NF-κB. We observed relative ICAM-1 and NF-κB mRNA levels by qRT-PCR method in a TNF-α- induced inflammation model of saphenous vein endothelial cell culture after 0.1, 0.5, 1 and 5 μM of AA were applied to the cells. In addition, protein levels of ICAM-1 and NF-κB were evaluated by immunofluorescent staining. The results were compared between different concentrations of AA, and also with the control group. Results: It was found that 5 μM, 1 μM and 0.5 μM of AA had toxic effects, while cytotoxicity decreased when 0.1 μM of AA was applied both alone and with TNF-α. When AA was applied with TNF-α, there was a decrease and suppression in NF-κB expression compared with the TNF-α group. TNF-α-induced ICAM-1 expression was significantly reduced more in the AA-applied group than in the TNF-α group. Conclusion: In accordance with our results, it can be said that AA has a protective role in the pathogenesis of atherosclerosis and hence in saphenous vein graft disease.