Laboratory of Comorbidity in Cardiovascular Diseases, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation, RU.
Circulatory Pathology Laboratory, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation, RU.
Glob Heart. 2021 Dec 27;16(1):90. doi: 10.5334/gh.1053. eCollection 2021.
The study aim was to investigate the possibility of cardiovascular complications development predicting during a five-year follow-up of patients after coronary artery bypass grafting (CABG) using the cardio-ankle vascular index (CAVI) assessment.
Three hundred and fifty-six patients after elective CABG were enrolled in the study. Prior to surgery, arterial stiffness was assessed in all patients using CAVI. The follow-up was performed five years after the surgery, information was obtained on 238 patients, who were divided into two groups: patients with pathological (≥9.0, n = 88), and normal (<9.0, n = 150) CAVI.
Pathological CAVI (≥9.0) was detected in 33% patients before CABG, in stepwise analyses only age and left atrium dimensions statistically significantly predicted CAVI. In patients with pathological CAVI the combined endpoint (major adverse cardiovascular events and hospitalization) and cardiovascular death developed more often in a five-year follow-up after CABG compared with normal CAVI (48.86% versus 34.9%, p = 0.034 and 4.55% versus 0.67%, p = 0.049, respectively). Pathological CAVI (p = 0.021) and the number of coronary bypass grafts (p = 0.023) were independent factors associated with the combined endpoint.
Patients with pathological CAVI before CABG surgery are more likely to develop cardiovascular complications and cardiovascular death within a subsequent five-year follow-up. Evaluation of CAVI after CABG in dynamics deserves further study, it is important for monitoring the effects of secondary prevention and the possibility of influencing the prognosis.
使用脉波传导速度(CAVI)评估,研究冠状动脉旁路移植术(CABG)后 5 年随访期间心血管并发症发展的可能性。
本研究纳入了 356 例择期 CABG 患者。所有患者在手术前均使用 CAVI 评估动脉僵硬度。术后 5 年进行随访,获得了 238 例患者的信息,将其分为两组:CAVI 异常(≥9.0,n=88)和正常(<9.0,n=150)。
CABG 前 33%的患者 CAVI 异常(≥9.0),仅年龄和左心房尺寸在逐步分析中具有统计学意义,可预测 CAVI。在 CAVI 异常的患者中,与 CAVI 正常的患者相比,在 CABG 后 5 年的随访中,联合终点(主要不良心血管事件和住院)和心血管死亡的发生率更高(48.86%比 34.9%,p=0.034;4.55%比 0.67%,p=0.049)。CAVI(p=0.021)和冠状动脉旁路移植术数量(p=0.023)是与联合终点相关的独立因素。
CABG 术前 CAVI 异常的患者在随后的 5 年随访中更有可能发生心血管并发症和心血管死亡。CABG 后 CAVI 的动态评估值得进一步研究,对于监测二级预防的效果和影响预后的可能性很重要。