PREDICTORS OF EARLY SAPHENOUS-VEIN AORTOCORONARY BYPASS GRAFT OCCLUSION

To identify factors determining early saphenous vein aortocoronary byp ass occlusion, we analyzed the data base of the GESIC study, a trial c omparing antiplatelet drug regimens that included 927 patients with 1, 854 saphenous vein grafts. The univariate analysis showed female sex ( p < 0.0097), obesity (p < 0.001), rest angina (p < 0.0026), history of congestive heart failure (p < 0.037), the revascularized artery (p < 0.0001), the quality of distal bed (p < 0.00001), the diameter of the grafted vessel (p < 0.00001), the lack of antiaggregant treatment (p < 0.017), and a nonsequential technique (p < 0.0002) as predictors of e arly (28 days) graft occlusion. In the multivariate analysis the last five variables were independent predictors. Using the two preoperative variables, it was possible to identify groups at different risk; the occlusion rate ranged between 8.79% (left anterior descending coronary artery and good distal vessel) and 27.58% (right coronary artery or l eft circumflex coronary artery and poor distal vessel). The combinatio n of three variables (grafted vessel, artery diameter, and antiaggrega nt treatment) also allowed identification of different risk groups; th e occlusion rate ranged between 3.5% and 63.1%. Thus, it is possible t o anticipate the risk of graft occlusion in patients undergoing corona ry artery bypass grafting, which may help in the selection of both pat ients and antithrombotic treatment.