Improved success rate for coronary bypasses

A new drug promises to boost the success rate of coronary artery bypass surgery and keep the transplanted vessels open longer. Early findings from a study in Boston show that the “decoy” drug may provide a promising new approach that will prevent coronary and peripheral bypass failures. The new approach can be easily integrated into routine surgery.

Known as “E2F”, the compound boosts the activity of several genes that may be involved in the processes leading to the failure of a graft. Using an E2F “decoy” as a blockade could offer “a good single-agent strategy for prevention of graft disease”, according to the study’s authors.

In the study, which was published in a respected British journal (The Lancet), researchers soaked veins to be used for bypass grafting in a solution of the E2F-decoy before using them in surgery to bypass blocked coronary arteries. These veins showed 74 per cent less cellular overgrowth and thickening than those veins treated with other solutions.

Patients benefited from the E2F-decoy, with only three out of 15 patients in the E2F-decoy group (with open grafts) requiring repeat surgery. None had a critical narrowing of the grafted veins 12 months. Overall, 29 per cent of those in the E2F-decoy group had further heart problems or required heart treatment, compared to 69 per cent in the untreated group.

The results are very promising, and larger scale studies are planned to confirm these observations and study the long-term biology of the vein grafts.