Пятилетние результаты реваскуляризации миокарда больных стабильной ишемической болезнью сердца со стенозом ствола левой коронарной артерии и/или многососудистым поражением коронарного русла

Authors: N.Yu. Sokolova

Company: Tver «Regional clinical hospital», Peterburgskoe shosse, 105, Tver’, Region Tver’, 170036, Russian Federation

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Heading: Original articles

UDC: 616.127-089.844:616.12-005.4:616.132.2-007.271:616.132.2-002
DOI: https://doi.org/10.24022/1997-3187-2018-12-4-316-327

For citation: Sokolova N.Yu. Five-year results of myocardial revascularization in patients with stable coronary artery disease with stenosis of the left coronary artery and / or multivessel coronary disease. Creative Cardiology. 2018; 12 (4): 316–27 (in Russ.). DOI: 10.24022/1997-3187-2018-12-4-316-327

Received / Accepted:  12.11.2018/19.11.2018

Key Words: coronary heart disease coronary artery bypass grafting percutaneous coronary intervention survival repeated revascularization

Abstract

Objective. To compare the long-term results of various methods of coronary revascularization in patients with stable coronary artery disease (SCAD) with stenosis of the left coronary artery (LCA) and/or multivessel coronary lesion.

Material and methods. The observation period was 54.3±7 months. We examined 183 patients SCAD with stenosis of the LCA and/or multivessel lesions of the coronary arteries (KA): coronary artery bypass grafting (CABG) – 109 (60%), percutaneous coronary intervention (PCI) – 74 (40%). The observation period was 54.3±7 months. The primary endpoints: death from all causes, cardiac mortality, nonfatal heart attack (MI), nonfatal stroke. The secondary endpoint: re-coronary revascularization or the presence of indications for its conduct.

Results. 5-year follow-up period had no difference between CABG and PCI: overall survival (94.4% vs. 87.8 p=ns), cardiac lethality (3.6% vs. 8.1, p=ns), development of nonfatal MI (2.7% vs. 6.8, p=ns) and stroke (3.6% vs. 5.4, p=ns). Secondary endpoint: 2.7% vs. 21.6, CABG and PCI, p<0.001.

Conclusions. A nonrandomized 5-year prospective study comparing the two methods of coronary revascularization did not reveal differences in primary end points (general and cardiac mortality, nonfatal MI and stroke), but a statistically significant difference in the need and frequency of repeated myocardial revascularization was noted, as noted more often after endovascular interventions.

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About Authors

Natal'ya Y. Sokolova, Cand. Med. Sc., Cardiologist, orcid.org/0000-0002-5720-304X

Chief Editor

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