Predictors for New Native-Vessel Occlusion in Patients with Prior Coronary Bypass Surgery: A Single-Center Retrospective Research.

ABSTRACT

OBJECTIVES: Chronic total occlusion (CTO) is prevalent in patients with prior coronary artery bypass grafting (CABG). However, data available concerning the prevalence of new-onset CTO of native vessels in patients with prior CABG is limited. Therefore, the objective of the study is to determine predictors for new native-vessel occlusion in patients with prior coronary bypass surgery. METHODS: 354 patients with prior CABG receiving follow-up angiography are selected and analyzed in the present study, with clinical and angiographic variables being analyzed by logistic regression to determine the predictors of new native-vessel occlusion. RESULTS: The overall new occlusion rate was 35.59%, with multiple CTOs (42.06%) being the most prevalent (LAD 24.60% and RCA 18.25%, respectively). Additionally, current smoking (OR 2.67; 95% CI 2.60 to 2.74; p=0.01), reduced ejection fraction (OR 1.76; 95% CI 1.04 to 2.97; p=0.04), severe stenosis (OR 3.65; 95% CI 2.55 to 5.24; p=0.01), and diabetes mellitus (OR 1.86; 95% CI 1.34 to 2.97; p=0.04) serve as the independent predictors for new native-vessel occlusion. CONCLUSION: As to high incidence of postoperative CTO, appropriate revascularization strategies and postoperative management should be taken into careful consideration.