Comparsion between coronary artery bypass grafting and percutan coronary intervention for proximal atherosclerotic progression in the native arteries

Comparison Between Coronary Artery Bypass Grafting and Percutan Coronary Intervention for proximal Atherosclerotic Progression in the Native ArteriesAtherosclerosis continue to progress in the native arteries and graft arteries after the coronary artery by-pass grafting operation (CABG). As a result of that, new lesions may develop or progression of known lesions accelerate. Usually, after the CABG surgery treatment strategy was planned regarding the graft lesions or lesions in the native arteries after the graft-native junction site. In contrast lesions which were located proximally to the graft-native junction site may also progress. Clinical importance of this issue hasn?t been known yet. In our study we investigated the atherosclerosis progression of proximally located native artery lesions after the CABG surgery and we compared CABG and percutanous coronary intervention for this lesion progression.One hundred CAD patients (50 patients had CABG and 50 patients had PCI) (79 male, 21 female and mean age: 60.1 ± 9.6 years) were enrolled the retrospective study. All subjects had control coronary angiography (CAG) after the interventional therapy and surgery. Histories, demographics data, and cardiovascular risk factors were recorded. Two-experienced cardiologist analyzed all angiograms and CAD severity score was calculated by using Gensini score. In control CAG, marked progression was defined as increasing >20% of norrowing in the mildly diseased coronary segments or devalopment of new lesions which can cause >20 % narrowing of previously normal segments.42 (84%) patients in CABG population and 25 (50%) patients in PCI population had proximal atherosclerosis progression (p=0.001). Occurence of proximal atherosclerosis progression was statistically significant in CABG group (p=0,001). There were no significant distal atherosclerosis progression between CABG and PCI group (30% and 14%, respectively).In conclusion, significant proximal atherosclerosis progression was found in patients with CABG. Further studies may help to define the clinical importance of this issue.