Preoperative lipid control with simvastatin protects coronary artery bypass grafts from obstructive graft disease

Coronary artery bypass grafting (CABG) is a regularly used treatment modality for myocardial revascularization. Progression of atherosclerosis results in obstructive lesions in vein grafts,(1-4) and vein grafts have a high early graft occlusion rate.(3) Almost 50% of vein grafts show detectable obstructive lesions within the first year.(4) A recent prospective randomized study showed a significant reduction of postoperative graft complications in patients with preoperative total plasma cholesterol > 240 mg/dl, when preoperative lipid control was achieved using simvastatin.(5) Patients from that study were followed clinically and underwent control angiography at 1 and at 2 years after CABG to evaluate the progression of obstructive graft disease.