Simonenko V B, Borisov I A, Bletkin A N, Zakharov S V, Dalinin V V
Klin Med (Mosk). 2008;86(3):13-7.
The aim of the study was comparative analysis of long-term results (5 years) after coronary angioplasty and stenting (CAS) and coronary artery bypass grafting (CABG). The results of the treatment of 1100 patients with coronary heart disease, operated since 1999 to 2006 year, were analyzed. 720 (65.5%) patients had undergone CABG (group 1), 226 (20.5%) had had an implantation of stents with pharmaceutical coverage (group 2) 154 (14%) had been implanted with stents without pharmaceutical coverage (group 3). Clinical examination as a rule had occurred before operation, 29-30 days after operation and in every 12 months after discharge from the hospital. Five years survival rate in group of CABG patients was 85.9% and in groups of CAS patients it was 84.1% and 70.8% respectively. Restenosis occurred more frequently in CAS patients: in group 2 in 18.1% patients, in group 3--in 70.1% In group of CABG patients acute myocardial infarction occurred in 11.9% cases to the end of 5th year, in groups 2 and 3 this index was 10.9% and 18.3% respectively. Angina pectoris was absent in 1 year in CABG patients (62%) than in CAS patients (46.7% and 24.3% in groups 2 and 3 respectively; p < 0.05). Comparing results of CAS with use of stents with and without pharmaceutical coverage, the best clinical result was in the group with implanted stents of new generation. Relatively better clinical effect during 5 years occurred in CABG patients.
本研究的目的是对冠状动脉血管成形术和支架植入术（CAS）以及冠状动脉旁路移植术（CABG）后的长期结果（5年）进行比较分析。分析了1999年至2006年期间接受手术的1100例冠心病患者的治疗结果。720例（65.5%）患者接受了CABG（第1组），226例（20.5%）接受了药物涂层支架植入（第2组），154例（14%）接受了无药物涂层支架植入（第3组）。通常在手术前、术后29 - 30天以及出院后每12个月进行临床检查。CABG患者组的5年生存率为85.9%，CAS患者组的5年生存率分别为84.1%和70.8%。CAS患者再狭窄发生率更高：第2组为18.1%的患者，第3组为70.1%。到第5年末，CABG患者组急性心肌梗死发生率为11.9%，第2组和第3组该指标分别为10.9%和18.3%。CABG患者术后1年无心绞痛的比例（62%）高于CAS患者（第2组和第3组分别为46.7%和24.3%；p < 0.05）。比较使用有药物涂层和无药物涂层支架的CAS结果，最佳临床结果出现在植入新一代支架的组中。CABG患者在5年期间临床效果相对更好。
