Lipids and Lipid-Lowering Drugs and Graft Function
There is a relationship between the type of graft changes and the time since operation. (a) Thrombotic events are almost exclusively responsible for early graft closures and account for an attrition rate of 10% by 1 month after operation . (b) By the end of the first postoperative year a further 10% loss of patent bypasses has occurred because of intimal fibromuscular hypertrophy. (c) Atherosclerotic plaque, in contrast, is not detectable prior to the end of the first year after operation and is rarely observed before the end of the second or third year [1, 2, 23, 30-32]. Plaques are observed histologically in 21% of grafts at a mean of 5 years after operation; about one-third of grafts at this time have more than 75% atherosclerotic obstructions, and a further one-third have total occlusions secondary to atherosclerosis. In one study, atherosclerosis — defined as intimal foam cell accumulation or frank plaques — was found only 39 or more months after operation and was present in 79% of such cases . Consistent with the temporal sequence of graft changes, all atherosclerotic grafts show some degree of intimal fibromuscular proliferation.
KeywordsPlacebo Cholesterol Lipase Aspirin Cardiol
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