ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Cholestryl ester transfer protein and reoperative coronary artery surgery
Onur Göksel, Bayer Çınar, Veysel Şahin, Sinan Kut, Uğur Filizcan, Şebnem Çetemen, Olgar Bayserke, Ergin Eren
Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul
Background: The activity of cholesteryl ester transfer protein (CETP) has been assessed in patients with occluded grafts following coronary artery bypass grafting (CABG).

Methods: Twenty patients undergoing re-operative CABG (group 1) between June, 2003 and November, 2004 were prospectively compared with control groups (20 patients undergoing primary, isolated CABG -group 2 and 20 patients undergoing isolated non-ischemic valvular procedures- group 3) for CETP activity, pre-, peri- and postoperative data including hospital mortality and mortality. For statistical reason, groups 2 and 3 were denominated as ‘group B’ which delineates progressive atherosclerosis in some evaluations.

Results: Cholesteryl ester transfer protein activity was highest in group 1 (14.28±3.87; 5.42±3.59; 7.08±3.87 in groups 1-3, respectively; p<0.05). 50% of patients in group 1 had a three-graft CABG (2.85±0.99 grafts/patient). One patient expired in group 1; two of three cases of perioperative myocardial infarction were from group 1. Cholesteryl ester transfer protein activity higher than 9.34 was recognized as the limit of progressive atherosclerosis. Area under the receiver operator characteristic curve (ROC) was 0.085 indicating that the analysis was very good.

Conclusion: Screening younger patients for CETP activity may predict middle and long term prognosis and the use of “athero-resistant” grafts (e.g. arterial grafts) may be particularly important in those patients with a CETP activity above the cut-off point of 9.34.

Keywords : Cholesterol ester/metabolism; coronary arteriosclerosis; coronary artery bypass; reoperation
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