Search for: [Abstract = "In spite of the rapid developments in invasive cardiology, coronary artery bypass grafting \(CABG\) remains the treatment of choice in diabetic patients with multivessel coronary artery disease, long\-segment lesions and chronic total occlusion, and the left main coronary artery stenosis or its equivalent. High number of CABG procedures performed in the last decades has a great impact on the increasing number of patients \(pts\) with recurrent angina due to a saphenous vein graft \(svg\) disease or native vessel \(nv\) atherosclerosis progression. Atherosclerosis progression and bypass graft degeneration limit long\-term outcome in pts after CABG. The surgical treatment has no effect on the mechanism of the atherosclerotic disease\; bypass grafts \(and in particular the venous ones\) are known to degenerate with time. Thus surgical revascularization has created a new problem in cardiology – the problem of degenerative bypass graft disease. Inflammatory factors influence pathogenesis and natural course of native vessel and bypass graft atherosclerosis. Percutaneous procedures have become a natural, logical alternative to surgery in pts with recurrent angina after CABG. AIM\: To assess the mechanism of angina recurrence in a series of consecutive pts after CABG and to evaluate the feasibility of re\-revascularization by percutaneous coronary intervention \(PCI \) or reCABG. To assess the relationship between non\-specific \(e.g., hs\-CRP\) and specific \(e.g., chlamydia pneumoniae, ChP\), inflammatory markers and immediate and mid\-term outcome in patients undergoing PCI after CABG. To assess the immediate and long\-term outcome of PCI in patients after CABG and identify prognostic factors of major adverse cardiac events \(MACE\) in a long term follow\-up.Two hundred and thirty six consecutive pts \(81.4% men, mean age 63.1±8.2, range 40\-82 years\) undergoing cardiac catheterizations for recurrent angina in the mean time of 93.2 ± 48.1 \(1\-267\) months after CABG were evaluated. The culprit lesion was identified on the basis of angiography of native vessels and coronary bypass grafts. Then the pts were qualified to PCI, reCABG or conservative therapy. Patients underwent long term clinical follow up, including the CCS class, recurrent cardiovascular hospitalization or occurrence of MACE \(such as death, heart infarct, repeated PCI\). The underlying cause of symptom recurrence was identified as follows\: svg insufficiency in 92 \(39%\) patients, atherosclerosis progression in native vessels in 44 \(18.6%\) patients. Both reasons for symptom recurrence were seen in 59 \(25%\) patients. In 41 \(17.4%\) pts patent, properly performing bypass grafts were found in the absence of nv atherosclerosis progression\; thus the reason for symptom recurrence in those pts remains unidentified. In a great majority of pts \(178, i.e. 91%\) symptoms recurred over a year after CABG and the predominant reason was svg occlusion. A correlation was found between the time of symptom recurrence after CABG and age \(p=0.026, r= \-0.159\) and white blood account \(p=0.0004, r= \-0.252\). However, there was no correlation between the time of symptom recurrence and hs\-CRP \(p=0.038, r= \- 0.181\). The search for independent factors of the time of angina recurrence after CABG was performed. This revealed the following predictors\: atherosclerosis progression in native vessels, lack of IMA use as a graft, hyperlidaemia, and elevated white blood count. Among the 195 pts with angiographically identified reason of symptom recurrence, 141 \(72.3%\) pts were referred to re\-revascularization due to atherosclerosis progression in native vessels or\/and coronary bypass grafts \(svg insufficiency\/degeneration\). In the remaining 54 \(27.7%\) pts there was no anatomical option for re\-revascularization \(neither PCI nor reCABG\).PCI was performed in 132 \(67.7%\) patients, and 9 \(4.6%\) pts were referred to re\-CABG. Svg\-PCI was performed in 39\(25.5%\) pts, nv\-PCI in 80 \(60.6%\), and both nv\- and svg\-PCI in 13 \(9.8%\) pts."]