The impact of multifocal atherosclerosis on the early and late outcomes of planned endovascular treatment of ischemic heart disease
https://doi.org/10.29001/2073-8552-2014-29-3-87-93
Abstract
This paper presents a retrospective analysis of endovascular treatment of coronary artery disease (CAD) in patients with stable CAD in the Cardiac Rehabilitation Department (Research Institute for Cardiology, Tomsk) from 2010 to 2011. Data showed that the presence of concomitant multifocal atherosclerosis (MFA) was associated with more severe clinical condition of patients, larger baseline number of risk factors and comorbidities, and the absence of clinical signs of regression of coronary insufficiency and heart failure long-term after coronary intervention. The study showed that the presence of MFA did not increase the length of hospital stay and the rates of complication after endovascular treatment for stable coronary artery disease. Long-term outcomes of planned coronary stenting in patients with CAD associated with MFA were significantly worse in respect to such important events as all-cause mortality and stroke. One of the causes for the unfavorable course of the disease in this group of patients was the presence of significantly higher activity of the inflammatory processes.
About the Authors
E. O. Vershinina
Federal State Budgetary Institution "Research Institute for Cardiology" of Siberian Branch under the Russian Academy of Medical Sciences
Russian Federation
Russian Federation
A. N. Repin
Federal State Budgetary Institution "Research Institute for Cardiology" of Siberian Branch under the Russian Academy of Medical Sciences
Russian Federation
Russian Federation
T. R. Ryabova
Federal State Budgetary Institution "Research Institute for Cardiology" of Siberian Branch under the Russian Academy of Medical Sciences
Russian Federation
Russian Federation
References
1. Барабаш Л.С., Кашталап В.В., Зыков М.В. и др. Распространенность и клиническая значимость мультифокального атеросклероза у пациентов с инфарктом миокарда и подъемом сегмента ST // Кардиология и сердечно-сосудистая хирургия. - 2010. - № 5. - С. 31-36.
2. Вершинина Е.О., Репин А.Н., Рябова Т.Р. и др. Ближайшие и отдаленные результаты плановых эндоваскулярных вмешательств на коронарных артериях и влияние на них нарушений углеводного обмена // Сибирский медицинский журнал (Томск). - 2013. - Т. 28, № 4. - С. 28-35.
3. ВНОК. Диагностика и лечение стабильной стенокардии. Российские рекомендации (второй пересмотр) // Кардиоваскулярная терапия и профилактика. - 2008. - №7(6), прил. 4. - С. 1-28.
4. Гракова Е.В., Тепляков А.Т. Гендерные особенности эндоваскулярной коронарной реваскуляризации посредством стентирования коронарных артерий у больных, перенесших инфаркт миокарда: результаты 5-летнего проспективного наблюдения // Сибирский медицинский журнал (Томск). -2013. - Т. 28, № 4. - С. 19-28.
5. Сумин А.Н., Гайфулин Р.А., Безденежных А.В. и др. Распространенность мультифокального атеросклероза в различных возрастных группах // Кардиология. - 2012. - № 6. - С. 28-34.
6. Шальнова С.А., Деев А.Д. Тенденции смертности в России в начале ХХI века (по данным официальной статистики) // Кардиоваскулярная терапия и профилактика. - 2011. -Т. 10, № 6. - С. 5-10.
7. Alberts M.J., Bhatt D.L., Mas J.L. et al. Three-year follow-up and event rates in the international Reduction of Atherothrombosis for Continued Health Registry // Eur. Heart J. - 2009. - No. 30. - Р. 2318-2326.
8. Belch J.J., Topol E.J., Agnelli G. et al. Prevention of Atherothrombotic Disease Network. Critical issues in peripheral arterial disease detection and management: a call to action // Arch. Intern. Med. - 2003. - No. 163. - Р. 884-892.
9. Bhatt D.L., Peterson E.D., Harrington R.A. et al. Prior polyvascular disease: risk factor for adverse ischemic outcomes in acute coronary syndromes // Eur. Heart J. - 2009. - No. 30. - Р. 1195-1202.
10. Boden W.E., O’Rourke R.A., Teo K.K. et al. Optimal medical therapy with or without PCI for stable coronary disease // N. Engl. J. Med. - 2007. - No. 356. - Р. 1503-1516.
11. Cannon C.P. Revascularization for everyone? // Eur. Heart J. - 2004. - No. 25. - Р. 1471-1472.
12. Eagle K.A., Rihal C.S., Foster E.D. et al. Long-term survival in patients with coronary artery disease: importance of peripheral vascular disease. The Coronary Artery Surgery Study (CASS) Investigators // J. Am. Coll. Cardiol. - 1994. - No. 23. - Р. 1091-1095.
13. Granger C.B., Goldberg R.J., Dabbous O. et al. Predictors of hospital mortality in the global registry of acute coronary events // Arch. Intern. Med. - 2003. - No. 163. - Р. 2345-2353.
14. Hochman J.S., Sleeper L.A., White H.D. et al. One-year survival following early revascularization for cardiogenic shock // JAMA. - 2001. - No. 285. - Р. 190-192.
15. Kastrati A., Mehilli J., Pache J. et al. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents // N. Engl. J. Med. - 2007. - No. 356. - Р. 1030-1039.
16. Neumann F.J., Desmet W., Grube E. et al. Effectiveness and safety of sirolimus-eluting stents in the treatment of restenosis after coronary stent placement // Circulation. - 2005. - No. 111. -P. 2107-2111.
17. Van Kuijk J.P., Flu W.J., Welten G.M. et al. Long-term prognosis of patients with peripheral arterial disease with or without polyvascular atherosclerotic disease // Eur. Heart J. - 2010. -No. 31(8). - Р. 992-999.
Review
For citations:
Vershinina E.O., Repin A.N., Ryabova T.R. The impact of multifocal atherosclerosis on the early and late outcomes of planned endovascular treatment of ischemic heart disease. Siberian Journal of Clinical and Experimental Medicine. 2014;29(3):87-93. (In Russ.) https://doi.org/10.29001/2073-8552-2014-29-3-87-93
Views:
316
.png)
Email this article 