JOURNAL OF CLINICAL MEDICINE, vol.8, no.14, pp.1-11, 2025 (SCI-Expanded)
Background: Coronary artery bypass grafting (CABG) for the treatment of ischemic heart disease is still considered an effective treatment option to improve clinical outcomes and reduce mortality. However, the patency rates of saphenous vein grafts (SVGs) are significantly lower compared to those of arterial grafts. Atherosclerosis has emerged as one of the main causes of SVG stenosis (SVGS), especially stenoses that develop after one year. In this study, we aimed to investigate the association of glucose-to-lymphocyte ratio (GLR), a novel inflammatory biomarker, with LVG patency status in patients undergoing CABG surgery. Methods: A total of 778 patients who were diagnosed with chronic coronary syndromes (CCS) according to the 2019 ESC guidelines for the diagnosis and treatment of CCS; had undergone CABG more than one year previously; and had at least one SVG used during surgery were included in this study. GLR was calculated as blood glucose level (mg/dL) divided by lymphocyte count (K/uL). Results: SVGS was detected in 341 patients, while SVGs were intact in 437 patients. Patients with SVGS had a higher prevalence of diabetes mellitus (DM) (p = 0.002) and significantly higher blood glucose levels (p < 0.001). In addition, the interval between CABG operation and coronary angiography (CAG) was longer in the SVGS group (p < 0.001). Neutrophil levels were higher, and lymphocyte levels were lower in this group (p = 0.010 and p = 0.034, respectively). Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), glucose/lymphocyte ratio (GLR) and high-sensitivity C-reactive protein (CRP) levels were significantly higher in patients with SVGS (p < 0.001 for all). According to multivariate logistic regression analysis, DM, CRP level, time since CABG, and GLR were identified as independent predictors of SVGS (p = 0.004, p = 0.048, p < 0.001, and p < 0.001, respectively). ROC analysis showed that SVGS could be predicted with 75.8% sensitivity and 68.6% specificity when the cut-off value for GLR was >315.5 (area under the curve [AUC]: 0.801, 95% CI: 0.765–0.837, p < 0.001). Conclusions: Higher GLR levels are associated with SVGS in patients with coronary artery disease.