Study of the Saphenous Vein Graft in Diabetic and Non-Diabetic Patients with Coronary Artery Disease.

The burden of cardiovascular disease has steadily increased in India. The aim of this study was to examine the veins when they are harvested in patients undergoing CABG (coronary artery bypass grafting), prior to grafting, to look for early evidences of damage due to inflammatory processes & also for immunohistochemical evidence of inflammatory markers and to compare the findings in diabetic patients and non-diabetic patients. Materials And Methods: This study was as part of an Extramural Ad-Hoc ICMR funded project. After obtaining an informed consent, a total of 154 patients were enrolled. All patients underwent CABG & saphenous vein (SV) was harvested, sent to the lab for evaluation. The characteristic histopathological features were observed, the findings compared in both groups. Immunohistochemical evidence of inflammatory markers in the SV wall was looked for and staining for MMP-9, COX-2 and iNOS was evaluated. Florescent staining of the SV for alterations in the basement membrane was also done. Results: A predominant male population was observed with 61.68% diabetics, hypertension and hypercholestraemia were the major risk factors along with smoking. Subendothelial edema was the major histopathological finding seen. IHC staining for inflammatory markers MMP-9 and COX-2 was done and showed positive findings for both the inflammatory markers, Examination florescent staining was carried out to delineate the basement membrane. Fragmentation of the basement membrane with disruption and a fibrillary appearance was seen in patients with smoking and hypertension. A fragmented & homogenous / afibrillar basement membrane was seen in the saphenous vein of patients with diabetes. Conclusion: We inferred that quicker attrition of the vein grafts may be anticipated in individuals with significant histological findings. Studies with a larger sample size will help to further validate these conclusions. [ABSTRACT FROM AUTHOR]