Positive family history of coronary atherosclerosis and serum triglycerides may predict repeated coronary artery bypass surgery

Abstract

Objective. Cardiovascular risk factor profile of patients in need of repeated coronary artery bypass surgery (redo CABG) seldom differ from patients having only single coronary artery bypass surgery (CABG). The aim of this study was to analyse the influence of positive family history for coronary artery disease in respect to redo CABG vs CABG in a case-control setting. Design. One hundred and eighty four patients undergoing redo CABG between 1990–1998 were identified from the computed registry of the Department of Cardiothoracic Surgery in Tampere University Hospital. One hundred and eighty four age, gender and operation date matched patients with CABG were selected for control. Results. According to chi-square analysis, positive family history for coronary artery disease was more common in Study group, 60.4% versus 49.5% (p < 0.05). Preoperative systolic blood pressure was 135.5±1.4 mmHg versus 133.5±1.5 mmHg (ns), preoperative diastolic blood pressure was 81.2±0.8 mmHg versus 82.8±0.9 mmHg (ns), serum total cholesterol was 5.8±0.1 mmol/L versus 6.6±1.2 mmol/L and preoperative blood glucose was 5.6±0.2 mmol/L versus 5.3±0.2 mmol/L (ns) in Controls and Study group, respectively. However, serum triglyceride level was significantly higher in Study group 2.8±0.2 mmol/L versus 2.0±0.1 mmol/L (p < 0.000). In regression analysis, only positive family history (OR = 2.4; 95% CI = 1.1–5.1; p < 0,02) and high serum triglyceride level (≥2 mmol/L, OR = 1.6; 95% CI = 1.2–2.2; p < 0,02) were independent predictors for redo CABG. Conclusion. According to this study, positive family history for coronary atherosclerosis at the presence of high serum triglyceride level is significantly predicting the need for future redo CABG as compared with age, gender and operation time matched controls of CABG.