Preoperative lipid control with simvastatin protects coronary artery bypass grafts from obstructive graft disease

Coronary artery bypass grafting (CABG) is a regularly used treatment modali ty for myocardial revascularization. Progression of atherosclerosis results in obstructive lesions in vein grafts,(1-4) and vein grafts have a high ea rly graft occlusion rate.(3) Almost 50% of vein grafts show detectable obst ructive lesions within the first year.(4) A recent prospective randomized s tudy showed a significant reduction of postoperative graft complications in patients with preoperative total plasma cholesterol > 240 mg/dl, when preo perative lipid control was achieved using simvastatin.(5) Patients from tha t study were followed clinically and underwent control angiography at 1 and at 2 years after CABG to evaluate the progression of obstructive graft dis ease.