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Results of myocardial revascularization in patients with stable coronary artery disease with high SYNTAX Score

Authors: Sokolova N. Yu. 1, Shumkov K. V. 2, Kuznetsova E. V. 2, Golukhova E.Z. 2

Company: 1 Tver’ «Regional clinical hospital», Peterburgskoe shosse, 105, Tver’, Region Tver’, 170036, Russian Federation;
2 Bakoulev National Scientific and Practical Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Ischemic heart disease


DOI: https://doi.org/10.24022/1997-3187-2017-11-2-109-117

For citation: Sokolova N.Yu., Shumkov K.V., Kuznetsova E.V., Golukhova E.Z. Results of myocardial revascularization in patients with stable coronary artery disease with high SYNTAX Score. Kreativnaya kardiologiya (Creative Cardiology, Russian journal). 2017; 11 (2): 109–17 (in Russ.). DOI: http://dx.doi.org/10.24022/1997-3187-2017-11-2-109-117

Received / Accepted:  June 02, 2017 / June 14, 2017

Keywords: coronary artery disease coronary artery bypass surgery percutaneous coronary intervention survival rate repeat revascularization high SYNTAX Score

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Abstract

Objective. To assess and compare the efficacy and safety of coronary artery bypass grafting (CABG) and percutaneous coronary interventions (PCI) in patients with stable coronary artery disease (CAD) in treatment of coronary artery disease (CAD) with a high SYNTAX Score.

Material and methods. The study included 65 patients (mean age 63.8±5.9 years) who underwent CABG (n = 35) and PCI (n = 30). The primary endpoints were — death from any cause, cardiac death, nonfatal myocardial infarction (MI), nonfatal stroke. The secondary endpoint was repeat revascularizations or indications for this procedure. The mean time of follow-up was 37.9±6 months.

Results. In the early postoperative period lethal outcomes were registered only in the CABG group (8.6% (n = 3) versus 0, p=0.027). After 3 years of follow-up in CABG and PCI groups all-cause death was, concordantly, 9.7 and 10.3%, p=ns; cardiac death 6.5% vs 10.3, p=0.047; nonfatal MI 2.85% vs 10.0, p = 0.042; nonfatal stroke 5.7% vs 3.3, p=ns; the frequency of repeat revascularization 8.8% vs 17.2, p=0.038.

Gonclusion. The study compared CABG and PCI in patients with stable CAD with stenosis of the left main artery and/or multivessel CA disease with high SYNTAX Score and did not reveal significant differences between groups in long-term survival rate, but MACE (cardiac death and nonfatal myocardial infarction and repeat revascularization) were significantly higher in patients after PCI.

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About Authors

  • Sokolova Natal’ya Yur’evna, ORCID, Cand. Med. Sc., Cardiologist;
  • Shumkov Konstantin Valer’evich, Cand. Med. Sc., Cardiovascular Surgeon;
  • Kuznetsova Elena Vladislavovna, Cand. Med. Sc., Cardiologist;
  • Golukhova Elena Zelikovna, Academician of Russian Academy of Sciences, Professor, Dr Med. Sc., Head of Department

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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