Saphenous vein graft failure and clinical outcomes: toward a surrogate end point in patients following coronary artery bypass surgery?

Journal Article (Editorial)

Saphenous vein graft (SVG) failure is a common finding in patients following coronary artery bypass graft (CABG) surgery. In the literature SVG failure rates have been reported from 25 to over 50% within 10 years. Although common, it remains unclear to what extent SVG failure affects clinical outcome, due to differences in definition, patient selection and follow-up. Particularly the lack of agreement on a universal definition makes comparisons between studies, and therefore generalizability of associations with outcomes, challenging. We suggest using a definition of SVG failure that is based on imaging as well as clinical parameters, that includes reporting SVG failure on both graft and patient level. The use of non-invasive imaging may help improve follow-up rates, and provide a more accurate picture of the real incidence and clinical impact of SVG failure. Given the lack of supportive evidence showing a consistent association between SVG failure and major adverse cardiovascular events, SVG failure should not be considered a valid surrogate endpoint at this time.

Full Text

Duke Authors

Cited Authors

  • Harskamp, RE; Williams, JB; Hill, RC; de Winter, RJ; Alexander, JH; Lopes, RD

Published Date

  • May 2013

Published In

Volume / Issue

  • 165 / 5

Start / End Page

  • 639 - 643

PubMed ID

  • 23622900

Pubmed Central ID

  • PMC4089872

Electronic International Standard Serial Number (EISSN)

  • 1097-6744

Digital Object Identifier (DOI)

  • 10.1016/j.ahj.2013.01.019


  • eng

Conference Location

  • United States