Atherosclerosis Clinical Trial
Official title:
Coronary Artery Bypass Grafting: Factors Related to Late Events and Saphenous Graft Patency
The purpose of this study is to determine the relations between conventional and unconventional risk factors and adverse clinical events at follow-up (including coronary bypass patency) in patients undergoing surgical myocardial revascularization.
Coronary artery bypass grafting represents one of the most frequent surgical procedure
performed in the United States and Europe. The clinical benefit of myocardial
revascularization is related to freedom of adverse cardiovascular events and to graft
patency, above all of great saphenous vein, which is nowadays the main autologous vessel
used for grafting coronaries different from anterior interventricular artery. Unfortunately,
phenomena leading to early and, above all, late complications and to graft occlusion are not
fully clarified and it so not possible to explain interindividual and temporary variability
of progressive stenosis rate only on the basis of classical atherosclerosis risk factors.
The aim of our study is to prospectively study the role of conventional risk factors
(preoperative risk factors and clinical features) and of unconventional risk factors
(genetic polymorphisms, inflammation and coagulation markers) with saphenous late patency
and postoperative patients outcome, in particular with regard to adverse clinical events
(myocardial infarction, successive stenting procedures, arrhythmias etc.)and to bypass
patency.
Plasma venous samples will be collected the day before surgery, at discharge from the
hospital, and at follow-up from patients undergoing on-pump and off-pump coronary artery
bypass grafting and stored at -80°C; Patients will be followed-up periodically with visits
and telephone interviews, and will be also invited to undergo multislice (64 rows) CT scan
in order to assess graft patency between 12 and 24 months after surgery.
Finally the relation between conventional and unconventional risk factors with adverse
events at follow-up will be assessed with multivariable statistical models.
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Observational Model: Case-Only, Time Perspective: Prospective
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