Dynamics of the State of Arterial Stiffness as a Possible Pathophysiological Factor of Unfavorable Long-Term Prognosis in Patients after Coronary Artery Bypass Grafting.

Abstract

Patients with coronary artery disease (n = 251) in whom CAVI was assessed using the VaSera VS-1000 device before and one year after CABG. Groups with improved CAVI or worsened CAVI were identified. We assessed the following events at follow-up: all-causes death, myocardial infarction, and stroke/transient ischemic attack. All-causes death was significantly more common in the group with worsened CAVI (27.6%) than in the group with CAVI improvement (14.8%; p = 0.029). Patients with worsened CAVI were more likely to have MACE, accounting for 42.2% cases, compared with patients with CAVI improvement, who accounted for 24.5%; p = 0.008. Worsened CAVI (p = 0.024), number of shunts (p = 0.006), and the presence of carotid stenosis (p = 0.051) were independent predictors of death from all causes at 10-year follow-up after CABG. The presence of carotid stenosis (p = 0.002) and the group with worsened CAVI after a year (p = 0.008) were independent predictors of the development of the combined endpoint during long-term follow-up. Patients with worsening CAVI one year after CABG have a poorer prognosis at long-term follow-up than patients with improved CAVI. Future research would be useful to identify the most effective interventions to improve CAVI and correspondingly improve prognosis.