ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE

Aim. To compare long term results of different methods of myocardial revascularization in patients with stable ischemic heart disease.Material and methods. In the study, 352 patients included, with stable ischemic heart disease: mean age 57,6±7,7 y.o. underwent coronary bypass operation (CBG) — grou...

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Main Authors: N. Yu. Sokolova, E. Z. Golukhova, K. V. Shumkov, E. V. Kuznetsova
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2017-08-01
Series:Кардиоваскулярная терапия и профилактика
Subjects:
Online Access:https://cardiovascular.elpub.ru/jour/article/view/508
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author N. Yu. Sokolova
E. Z. Golukhova
K. V. Shumkov
E. V. Kuznetsova
author_facet N. Yu. Sokolova
E. Z. Golukhova
K. V. Shumkov
E. V. Kuznetsova
author_sort N. Yu. Sokolova
collection DOAJ
description Aim. To compare long term results of different methods of myocardial revascularization in patients with stable ischemic heart disease.Material and methods. In the study, 352 patients included, with stable ischemic heart disease: mean age 57,6±7,7 y.o. underwent coronary bypass operation (CBG) — group 1 (n=183) and percutaneous coronary interventions (PCI) — group 2 (n=169) with drug eluting stents implantation (1st generation — Taxus, Cypher), with high treatment adherence — medication treatment in postsurgery period. Each group was selected to 2 subgroups: 1 subgroup with 1-2 vessel disease, 2 subgroup with main left coronary artery stem disease and/or severe multivessel disease. Primary endpoints: all-cause mortality, cardiac mortality, non-fatal myocardial infarction, non-fatal stroke. Secondary endpoint: repeated revascularization or appearance of indications to it. Mean time of follow up after CBG was 37,9±6 months.Results. In long term period there were no differences in survival between groups CBG and PCI neither in 1-2-vessel lesion (95,5% vs. 96,8%), nor with stem stenosis or multivessel disease — 95,6% vs 94,1%. Also, there were differences in survival rate depending on the grade of patient comorbidity, regardless revascularization method. There were no differences in groups 1 and 2 in cardiac mortality, nonfatal events. Emerging of indications for repeated myocardial revasculariztion was significantly higher in subgroups with multivessel disease: free from revascularizations, respectively, 97,1% vs 88,0%, in CBG and PCI (p=0,34).Conclusion. Long term survival after PCI with drug eluting stents of 1st generation in comparison to CBG, does not show significant differences in patients with different severity of coronary arteries lesion and high adherence to treatment. However there is dependence on comorbidity evel. Repeated revascularization of myocardium is needed more oftenly after endovascular interventions in stem lesion and/or multivessel disease.
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spelling doaj.art-f1b7e6a3b5634522926c7eb14c0b10cf2023-03-13T07:23:26Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252017-08-01164253010.15829/1728-8800-2017-4-25-30464ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCEN. Yu. Sokolova0E. Z. Golukhova1K. V. Shumkov2E. V. Kuznetsova3ГБУЗ Тверской области "Областная клиническая больница"ФГБУ Научный центр сердечно-сосудистой хирургии им. А. Н. Бакулева Минздрава РоссииФГБУ Научный центр сердечно-сосудистой хирургии им. А. Н. Бакулева Минздрава РоссииФГБУ Научный центр сердечно-сосудистой хирургии им. А. Н. Бакулева Минздрава РоссииAim. To compare long term results of different methods of myocardial revascularization in patients with stable ischemic heart disease.Material and methods. In the study, 352 patients included, with stable ischemic heart disease: mean age 57,6±7,7 y.o. underwent coronary bypass operation (CBG) — group 1 (n=183) and percutaneous coronary interventions (PCI) — group 2 (n=169) with drug eluting stents implantation (1st generation — Taxus, Cypher), with high treatment adherence — medication treatment in postsurgery period. Each group was selected to 2 subgroups: 1 subgroup with 1-2 vessel disease, 2 subgroup with main left coronary artery stem disease and/or severe multivessel disease. Primary endpoints: all-cause mortality, cardiac mortality, non-fatal myocardial infarction, non-fatal stroke. Secondary endpoint: repeated revascularization or appearance of indications to it. Mean time of follow up after CBG was 37,9±6 months.Results. In long term period there were no differences in survival between groups CBG and PCI neither in 1-2-vessel lesion (95,5% vs. 96,8%), nor with stem stenosis or multivessel disease — 95,6% vs 94,1%. Also, there were differences in survival rate depending on the grade of patient comorbidity, regardless revascularization method. There were no differences in groups 1 and 2 in cardiac mortality, nonfatal events. Emerging of indications for repeated myocardial revasculariztion was significantly higher in subgroups with multivessel disease: free from revascularizations, respectively, 97,1% vs 88,0%, in CBG and PCI (p=0,34).Conclusion. Long term survival after PCI with drug eluting stents of 1st generation in comparison to CBG, does not show significant differences in patients with different severity of coronary arteries lesion and high adherence to treatment. However there is dependence on comorbidity evel. Repeated revascularization of myocardium is needed more oftenly after endovascular interventions in stem lesion and/or multivessel disease.https://cardiovascular.elpub.ru/jour/article/view/508ишемическая болезнь сердцакоронарное шунтированиечрескожные коронарные вмешательстввыживаемостьповторная реваскуляризация миокарда
spellingShingle N. Yu. Sokolova
E. Z. Golukhova
K. V. Shumkov
E. V. Kuznetsova
ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE
Кардиоваскулярная терапия и профилактика
ишемическая болезнь сердца
коронарное шунтирование
чрескожные коронарные вмешательств
выживаемость
повторная реваскуляризация миокарда
title ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE
title_full ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE
title_fullStr ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE
title_full_unstemmed ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE
title_short ANALYSIS OF LONG TERM RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE WITH A HIGH LEVEL OF TREATMENT ADHERENCE
title_sort analysis of long term results of myocardial revascularization in patients with stable ischemic heart disease with a high level of treatment adherence
topic ишемическая болезнь сердца
коронарное шунтирование
чрескожные коронарные вмешательств
выживаемость
повторная реваскуляризация миокарда
url https://cardiovascular.elpub.ru/jour/article/view/508
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AT kvshumkov analysisoflongtermresultsofmyocardialrevascularizationinpatientswithstableischemicheartdiseasewithahighleveloftreatmentadherence
AT evkuznetsova analysisoflongtermresultsofmyocardialrevascularizationinpatientswithstableischemicheartdiseasewithahighleveloftreatmentadherence