{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:13:01Z","timestamp":1773087181260,"version":"3.50.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold> Coronary artery bypass grafting (CABG) success is reduced by graft occlusion. Understanding factors associated with graft occlusion may improve patient outcomes. The aim of this study was to develop a predictive risk score for saphenous vein graft (SVG) occlusion after CABG.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This retrospective cohort study enrolled 3,716 CABG patients from January 2012 to March 2013. The development cohort included 2,477 patients and the validation cohort included 1,239 patients. The baseline clinical data at index CABG was analyzed for their independent impact on graft occlusion in our study using Cox proportional hazards regression. The predictive risk scoring tool was weighted by beta coefficients from the final model. Concordance (c)-statistics and comparison of the predicted and observed probabilities of predicted risk were used for discrimination and calibration.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 959 (25.8%) out of 3,716 patients developed at least one late SVG occlusion. Significant risk factors for occlusion were female sex [beta coefficients (\u03b2) = 0.52], diabetes (\u03b2 = 0.21), smoking (currently) (\u03b2 = 0.32), hyperuricemia (\u03b2 = 0.22), dyslipidemia (\u03b2 = 0.52), prior percutaneous coronary intervention (PCI) (\u03b2 = 0.21), a rising number of SVG (\u03b2 = 0.12) and lesion vessels (\u03b2 = 0.45). On-pump surgery (\u03b2 = \u22120.46) and the use of angiotensin-converting enzyme inhibitors (ACEI)\/angiotensin receptor blockers (ARB) (\u03b2 = \u22120.59) and calcium channel blockers (CCB) (\u03b2 = \u22120.23) were protective factors. The risk scoring tool with 11 variables was developed from the derivation cohort, which delineated each patient into risk quartiles. The c-statistic for this model was 0.71 in the validation cohort.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> An easy-to-use risk scoring tool which included female sex, diabetes, smoking, hyperuricemia, dyslipidemia, prior PCI, a rising number of SVG and lesion vessels, on-pump surgery, the use of ACEI\/ ARB and CCB was developed and validated. The scoring tool accurately estimated the risk of late SVG occlusion after CABG (c-statistic = 0.71).<\/jats:p>","DOI":"10.3389\/fcvm.2021.670045","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T06:21:33Z","timestamp":1628749293000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Novel Risk Scoring Tool to Predict Saphenous Vein Graft Occlusion After Cardiac Artery Bypass Graft Surgery"],"prefix":"10.3389","volume":"8","author":[{"given":"Yujing","family":"Cheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoteng","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingxin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingkai","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujie","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1161\/01.CIR.97.9.916","article-title":"Aortocoronary saphenous vein graft disease: pathogenesis, predisposition, and prevention","volume":"97","author":"Motwani","year":"1998","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"I454","DOI":"10.1161\/CIRCULATIONAHA.105.001149","article-title":"Occurrence and risk factors for reintervention after coronary artery bypass grafting","volume":"114","author":"Sabik","year":"2006","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/j.jcin.2011.03.018","article-title":"Percutaneous coronary intervention in native arteries versus bypass grafts in prior coronary artery bypass grafting patients: a report from the National Cardiovascular Data Registry","volume":"4","author":"Brilakis","year":"2011","journal-title":"JACC Cardiovasc Interv."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1016\/S0828-282X(09)70486-6","article-title":"Coronary vein graft disease: pathogenesis and prevention","volume":"25","author":"Parang","year":"2009","journal-title":"Can J Cardiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1161\/CIRCULATIONAHA.117.027597","article-title":"Mechanisms, consequences, and prevention of coronary graft failure","volume":"136","author":"Gaudino","year":"2017","journal-title":"Circulation."},{"key":"B6","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1093\/icvts\/ivw372","article-title":"Graft patency is associated with higher health-related quality of life after coronary artery bypass surgery","volume":"24","author":"Samano","year":"2017","journal-title":"Interact Cardiovasc Thorac Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.1016\/j.jacc.2004.08.064","article-title":"Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study","volume":"44","author":"Goldman","year":"2004","journal-title":"J Am Coll Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1038\/nrcardio.2016.76","article-title":"Vein graft failure: from pathophysiology to clinical outcomes","volume":"13","author":"de Vries","year":"2016","journal-title":"Nat Rev Cardiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1097\/SLA.0b013e318288c38d","article-title":"Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions","volume":"257","author":"Harskamp","year":"2013","journal-title":"Ann Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1038\/s41569-019-0249-3","article-title":"Saphenous vein grafts in contemporary coronary artery bypass graft surgery","volume":"17","author":"Caliskan","year":"2020","journal-title":"Nat Rev Cardiol."},{"key":"B11","first-page":"877","article-title":"Relative importance of patient, procedural and anatomic risk factors for early vein graft thrombosis after coronary artery bypass graft surgery","volume":"52","author":"McLean","year":"2011","journal-title":"J Cardiovasc Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1016\/S0735-1097(99)00404-0","article-title":"Worse clinical outcome but similar graft patency in women versus men one year after coronary artery bypass graft surgery owing to an excess of exposed risk factors in women. CABADAS. Research Group of the Interuniversity Cardiology Institute of The Netherlands. Coronary Artery Bypass graft occlusion by Aspirin, Dipyridamole and Acenocoumarol\/phenoprocoumon Study","volume":"34","author":"Tan","year":"1999","journal-title":"J Am Coll Cardiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1016\/j.jtcvs.2009.11.045","article-title":"Lower graft patency after off-pump than on-pump coronary artery bypass grafting: an updated meta-analysis of randomized trials","volume":"140","author":"Takagi","year":"2010","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jtcvs.2019.07.086","article-title":"Development of a risk score for early saphenous vein graft failure: an individual patient data meta-analysis","volume":"160","author":"Antonopoulos","year":"2020","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1161\/CIRCULATIONAHA.113.008193","article-title":"Saphenous vein graft failure after coronary artery bypass surgery: insights from PREVENT IV","volume":"130","author":"Hess","year":"2014","journal-title":"Circulation."},{"key":"B16","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1016\/j.athoracsur.2004.07.047","article-title":"Comparison of saphenous vein and internal thoracic artery graft patency by coronary system","volume":"79","author":"Sabik","year":"2005","journal-title":"Ann Thorac Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1161\/01.CIR.93.1.42","article-title":"Smoking and cardiac events after venous coronary bypass surgery. A 15-year follow-up study","volume":"93","author":"Voors","year":"1996","journal-title":"Circulation."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1002\/sim.1742","article-title":"Presentation of multivariate data for clinical use: the Framingham Study risk score functions","volume":"23","author":"Sullivan","year":"2004","journal-title":"Stat Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/ejhf.32","article-title":"Predicting survival in heart failure: validation of the MAGGIC heart failure risk score in 51,043 patients from the Swedish heart failure registry","volume":"16","author":"Sartipy","year":"2014","journal-title":"Eur J Heart Fail."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1001\/jama.2017.12126","article-title":"Discrimination and calibration of clinical prediction models: users' guides to the medical literature","volume":"318","author":"Alba","year":"2017","journal-title":"JAMA."},{"key":"B21","doi-asserted-by":"publisher","first-page":"55","DOI":"10.7326\/M14-0697","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement","volume":"162","author":"Collins","year":"2015","journal-title":"Ann Intern Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1056\/NEJMoa0804626","article-title":"Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease","volume":"360","author":"Serruys","year":"2009","journal-title":"N Engl J Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.atherosclerosis.2006.07.008","article-title":"Renal dysfunction increases the risk of saphenous vein graft occlusion: results from the Post-CABG trial","volume":"193","author":"Wellenius","year":"2007","journal-title":"Atherosclerosis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1056\/NEJMoa1614341","article-title":"Five-year outcomes after on-pump and off-pump coronary-artery bypass","volume":"377","author":"Shroyer","year":"2017","journal-title":"N Engl J Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"39","DOI":"10.2147\/TCRM.S232033","article-title":"Uric acid and arterial stiffness","volume":"16","author":"Albu","year":"2020","journal-title":"Ther Clin Risk Manage."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1093\/cvr\/cvx177","article-title":"Interleukin-9 mediates chronic kidney disease-dependent vein graft disease: a role for mast cells","volume":"113","author":"Zhang","year":"2017","journal-title":"Cardiovasc Res."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1016\/j.athoracsur.2013.10.045","article-title":"Comparison of graft patency between off-pump and on-pump coronary artery bypass grafting: an updated meta-analysis","volume":"97","author":"Zhang","year":"2014","journal-title":"Ann Thorac Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1093\/ejcts\/ezy213","article-title":"The effect on survival from the use of a saphenous vein graft during coronary bypass surgery: a large cohort study","volume":"54","author":"Royse","year":"2018","journal-title":"Eur J Cardiothorac Surg."},{"key":"B30","doi-asserted-by":"publisher","first-page":"S213","DOI":"10.1161\/CIRCULATIONAHA.112.000328","article-title":"Correlates of saphenous vein graft hyperplasia and occlusion 1 year after coronary artery bypass grafting: analysis from the CASCADE randomized trial","volume":"128","author":"Une","year":"2013","journal-title":"Circulation."},{"key":"B31","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/S0003-4975(97)00017-9","article-title":"The Society of Thoracic Surgeons National Cardiac Surgery Database: current risk assessment","volume":"63","author":"Edwards","year":"1997","journal-title":"Ann Thorac Surg."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1161\/01.CIR.100.13.1464","article-title":"ACC\/AHA guidelines for coronary artery bypass graft surgery: executive summary and recommendations: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1991 guidelines for coronary artery bypass graft surgery)","volume":"100","author":"Eagle","year":"1999","journal-title":"Circulation."},{"key":"B33","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S1010-7940(99)00134-7","article-title":"European system for cardiac operative risk evaluation (EuroSCORE)","volume":"16","author":"Nashef","year":"1999","journal-title":"Eur J Cardiothorac Surg."},{"key":"B34","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1093\/ejcts\/ezs043","article-title":"EuroSCORE II","volume":"41","author":"Nashef","year":"2012","journal-title":"Eur J Cardiothorac Surg."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1016\/j.jvs.2011.04.039","article-title":"Circulating inflammatory cells are associated with vein graft stenosis","volume":"54","author":"Moreno","year":"2011","journal-title":"J Vasc Surg."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1111\/jcmm.12357","article-title":"Complement factor C5a induces atherosclerotic plaque disruptions","volume":"18","author":"Wezel","year":"2014","journal-title":"J Cell Mol Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/j.jcin.2011.12.017","article-title":"Pathology of drug-eluting versus bare-metal stents in saphenous vein bypass graft lesions","volume":"5","author":"Yazdani","year":"2012","journal-title":"JACC Cardiovasc Interv."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1016\/S0735-1097(00)00973-6","article-title":"Prognostic factors for atherosclerosis progression in saphenous vein grafts: the postcoronary artery bypass graft (Post-CABG) trial. Post-CABG Trial Investigators","volume":"36","author":"Domanski","year":"2000","journal-title":"J Am Coll Cardiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"b605","DOI":"10.1136\/bmj.b605","article-title":"Prognosis and prognostic research: validating a prognostic model","volume":"338","author":"Altman","year":"2009","journal-title":"BMJ."},{"key":"B40","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1136\/heartjnl-2011-301246","article-title":"Risk prediction models: I. Development, internal validation, and assessing the incremental value of a new (bio)marker","volume":"98","author":"Moons","year":"2012","journal-title":"Heart."},{"key":"B41","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/S0895-4356(01)00341-9","article-title":"Internal validation of predictive models: efficiency of some procedures for logistic regression analysis","volume":"54","author":"Steyerberg","year":"2001","journal-title":"J Clin Epidemiol."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.670045\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T06:21:38Z","timestamp":1628749298000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.670045\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,12]]},"references-count":41,"alternative-id":["10.3389\/fcvm.2021.670045"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.670045","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,12]]},"article-number":"670045"}}