Correlation between blood pressure control levels and long-term patency of saphenous vein grafts after coronary artery bypass grafting: a retrospective case-control study

Abstract

Background

The impact of aggressive blood pressure (BP) control (<130/80 mmHg) on vein graft disease progression following coronary artery bypass grafting remains unclear. This study evaluated the relationship between BP control on long-term graft patency in patients with hypertension post -coronary artery bypass grafting (CABG).

Methods

This retrospective, single-center, non-blinded case-control study initially enrolled 500 patients who underwent CABG at the Department of Cardiovascular Surgery, Xijing Hospital. Among them, 311 patients with comorbid hypertension and underwent coronary computed tomography angiography (CCTA) within three years postoperatively. Ultimately, 276 patients completed the follow-up of third year postoperatively and were included in the final statistical analysis. We conducted the correlation analysis between the BP control of the patients and the patency of long-term graft patency.

Results

Three years post-CABG, BP remained higher in the occlusion group (P < 0.05). The utilization rates of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) and calcium channel blockers (CCB) were higher in the non-occlusion group (68.11 % vs. 52.75 %, P = 0.013; 62.16 % vs. 48.35 %, P = 0.029). Logistic regression identified postoperative BP as an independent risk factor for vein graft occlusion (per patient, odds ratio [OR], 3.098; 95 % confidence interval [CI] 1.841–5.214, P < 0.001; per graft, OR, 2.600; 95 % CI 1.738–3.889, P < 0.001). No significant correlation was found between antihypertensive regimens and long-term vein graft patency.

Conclusions

Patients with hypertension whose BP was above 130/80 mmHg after CABG were more likely to develop vein graft restenosis. No significant correlation was observed between postoperative antihypertensive regimen and long-term vein graft patency post-CABG.