ArticleJournal of inflammation research2026
HDL-Adjusted Inflammatory Ratios and Sequential Graft Configuration are Associated with Mid-Term Saphenous Vein Graft Occlusion in a Post-CABG Angiography Cohort.
Article in Journal of inflammation research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Saphenous vein graft (SVG) failure limits long-term outcomes after coronary artery bypass grafting (CABG). HDL-adjusted inflammatory ratios, including the neutrophil-to-HDL ratio (NHDLr) and lymphocyte-to-HDL ratio (LHDLr), have emerged as markers of vascular inflammation, but their association with SVG occlusion in the post-CABG setting is unclear. We evaluated whether HDL-adjusted inflammatory ratios and sequential graft configuration are associated with mid-term SVG occlusion. Methods: This retrospective observational study included 190 post-CABG patients who underwent clinically indicated follow-up coronary angiography. Patients were categorized by the presence (n=72) or absence (n=118) of at least one occluded SVG. HDL-adjusted ratios were calculated from fasting blood tests obtained at the outpatient visit when angiography was planned. Multivariable logistic regression was used to identify independent predictors of SVG occlusion. Results: Patients with SVG occlusion had higher NHDLr (5.07 vs 4.41, p=0.006) and LHDLr (2.48 vs 2.15, p=0.012). Median time from CABG to index angiography was 40.9 months (IQR 23.5-66.5). Sequential grafting was more frequent in the occlusion group (33.3% vs 11.9%, p<0.001). In multivariable analysis, sequential grafting (adjusted OR 3.58, 95% CI 1.63-7.85), female sex (OR 2.05, 95% CI 1.06-3.94), NHDLr (OR 1.18, 95% CI 1.01-1.38), and LHDLr (OR 1.39, 95% CI 1.04-1.87) were independently associated with SVG occlusion. The combined model showed moderate discrimination (AUC 0.729). SVG occlusion was not associated with all-cause mortality during follow-up (p=0.566). Conclusion: In a post-CABG cohort undergoing follow-up angiography, elevated NHDLr and LHDLr and sequential grafting were independently associated with mid-term SVG occlusion. These findings support further validation of HDL-adjusted inflammatory ratios as accessible markers related to graft vulnerability in this setting.
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