Chest Pressure after CABG

My wife is 42 and had 4x CABG 1 year ago.  She is a diabetic - insulin dependent since early childhood- and has PAD.  Angina pain came back 3 months after her surgery and at 6 months she was given a clean bill of health from an angiogram.  Since that time her cholesterol has been 200+, bad hdl and bad ldl; her blood pressure runs usually around 140's/80's; she has returned to smoking and actually more now than ever (I know I know but I can't make her stop and believe me I have tried).  I notice she is taking many antacids and she admits to having chest pressure and jaw pain with exertion.  The cardiologist is firm that if her films were good at 6 months, theyu'll be clear now and I am concerned he is missing the boat because don't sapphenous ein grafts deteriorate quicker?  I am fearful  I will get home 1 day and she'll be dead.  She take insulin, Lipitor, Imdur.