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To the Editor: In the PREVENT IV study¹ comparing vein graft patency between patients receiving gene therapy with edifoligide vs placebo, the PREVENT IV investigators report a 1-year incidence of vein graft occlusion of 26.1% in the edifoligide group and 26.5% in the placebo group. Other contemporary multicenter angiographic studies in patients with a similar burden of coronary disease have found an incidence of 1-year vein graft occlusion of less than 15%,^2-3 substantially lower than that observed by the PREVENT IV investigators. In noting this difference, the authors suggest that the higher occlusion rate they observed may be due to more extensive and diffuse anatomic disease. To fully understand the role of target vessel characteristics on VGF, it would be helpful for the patency results to be stratified by quality and size of the target vessel.

An alternative explanation for the poor graft patency seen in this study may be . . . [Full Text of this Article]

Nimesh D. Desai, MD
nimesh.desai@utoronto.ca

Stephen E. Fremes, MD
Division of Cardiac Surgery
Sunnybrook and Women's College Health Sciences Centre
University of Toronto
Toronto, Ontario

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