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Background - Coronary artery bypass surgery with saphenous vein grafts is a well accepted treatment method of coronary artery disease despite the diminishing patency rates of saphenous vein grafts over time mainly due to the atherosclerotic process. Obesity has been shown to be a risk factor for coronary artery disease, but the impact of obesity on saphenous vein graft patency is less well described.This study was designed to examine the effect of obesity on the early and late saphenous venous graft stenosis. Methods - 676 consecutive patients (mean age 62.9 ± 9.7 years), undergoing a first-time coronary angiography after bypass surgery for recurrent angina were evaluated: body mass index was measured for 323 patients with at least one saphenous vein graft stenosis (group I) and 353 patients without saphenous vein graft stenosis (group 2). Results - There were no statistically significant differences in terms of hypertension, diabetes, smoking, hyperlipidaemia and gender as well as body mass index (BMI) status of the patients between the two groups (P > 0.05).The patients in both groups divided into obese and non-obese subgroups using a definition for obesity of BMI ≤ 30 and cumulative saphenous vein graft patency rates were evaluated as a function of time. Kaplan Meier curves showed that obese and non-obese patients had similar patency rates according to time since coronary artery bypass surgery (P > 0.743). Conclusion - Body mass index seems not to have an impact on the early and late saphenous venous disease in a group of consecutive patients admitted with recurrent angina.

OBJECTIVES Restenosis is the major limitation of coronary interventions occurring in nearly a third of the patients undergoing percutaneous transluminal coronary angioplasty (PTCA) with no single, definite predictor demonstrated in an individual patient. Platelets are known to play an important role in the pathogenesis of subsequent restenosis. METHODS AND RESULTS In a prospective study, follow-up coronary angiographies were performed in 102 consecutive patients with stable angina who underwent a successful PTCA for single-vessel coronary artery disease. Demographics, baseline lipid profiles (total cholesterol, HDL- and LDL-cholesterol, triglycerides) and haematological parameters (red cell, white cell and platelet counts, haemoglobin concentration, haematocrite %, mean platelet volume, platelet mass and fibrinogen levels) were compared between patients with and without restenosis. In the restenosis group, mean platelet volume (8.82 +/- 0.78 fl vs. 8.13 +/- 0.64 fl, p < 0.001), white cell count (8673 +/- 322 x 10(3)/microl vs. 7513 +/- 232 x 10(3)/microl, p < 0.01) and fibrinogen level (4.2 +/- 1.4 g/l vs 3.6 +/- 1.1 g/l) were significantly higher. The relative odds for developing angiographically defined restenosis were 2.49 times greater in diabetics (p = 0.11) and 2.54 times greater in men (p = 0.13). It is 1.43 times greater in patients with higher fibrinogen levels (p = 0.16). But, the relative odds for developing restenosis were 10.43 times greater in patients with larger pre-procedural mean platelet volumes (p < 0.01). CONCLUSIONS There was a positive correlation between mean platelets volume and loss in luminal diameter between post-angioplasty and follow-up angiographies (r = +2.345, p = 0.01). There was no association between restenosis and haemoglobin, haematocrit, red cell count, white cell count, platelet count, platelet mass and plasma fibrinogen level. The development of restenosis after successful coronary angioplasty may be mainly influenced by the platelet size.

Objective - Dilated cardiomyopathy has been associated with left ventricular thrombosis, which leads to substantial morbidity and mortality as a site for peripheral emboli.There are some studies on patients with dilated cardiomyopathy showing altered haemostasis and platelet behaviour despite sinus rhythm. Mean platelet volume, which is the most accurate and simple estimate of platelet reactivity, may be associated with the development of left ventricular thrombosis. Methods and results - We prospectively enrolled 48 consecutive patients with dilated cardiomyopathy and sinus rhythm with left ventricular thrombosis and compared them with an age-sex-matched control group having dilated cardiomyopathy without left ventricular thrombosis.We found that in patients with left ventricular thrombosis mean platelet volume is significantly higher than those without (9.5 ′ 0.8 vs. 8.7 ′ 0.6, p < 0.001). Conclusions - Mean platelet volume is increased in patients with dilated cardiomyopathy and sinus rhythm having left ventricular thrombosis. This might be reflecting a causal relationship, which in turn requires further study to establish the role of antiplatelet agents both in prevention and in treatment.

Coronary steal due to an unligated side branch of the internal mammary artery graft is a rare but important pathology causing ischaemia. We describe the case of a patient with significant ischaemia having an unligated side branch of the left internal mammary artery after coronary artery bypass surgery and who underwent coil embolization of the side branch.