Kremneva L V, Suplotov S N, Abaturova O V, Stognii N I, Shalaev S V
Tyumen State Medical University.
Ter Arkh. 2022 Aug 12;94(7):822-826. doi: 10.26442/00403660.2022.07.201740.
Evaluation of the frequency hospital cardiovascular events in groups of patients with stable angina who underwent percutaneous coronary interventions (PCI) with stenting of the arteries before coronary bypass surgery, or who did not have previous myocardial revascularization.
The 120 patients with stable angina who underwent routine coronary artery bypass grafting were examined. Group composition: Men 80.8%, age 587.6, duration of coronary heart disease 65.7 years, history of myocardial infarction (MI) 77.5%. Arterial hypertension was present in 92.5%, diabetes mellitus in 12.5% of patients. Multivessel coronary artery disease in 72.5% of patients. 28 (23.4%) patients had previously undergone PCI with stenting of the coronary arteries. The period from PCI to coronary bypass surgery was 2032.6 months. Coronary bypass surgery on-pump was performed in 88.3%, coronary bypass surgery on off-pump in 11.7%. The number of distal anastomoses ranged from 1 to 4.
There were no differences in clinical and angiographic indicators, pharmacotherapy, and operation characteristics between the groups of patients who were subjected to or did not have PCI before coronary bypass surgery. There were no differences between the analyzed groups of patients in the frequency of cardiac death (0 and 1.1%, p=0.58), non-fatal MI (3.6% and 9.8%, p=0.29), stroke (0 and 1.1%, p=0.58), acute heart failure (11.7% and 34.8%, p=0.06), the number of patients with paroxysms of atrial fibrillation (28.6% and 17.4%, p=0.94), the proportion of patients with resternotomies (3.6% and 3.3%, p=0.94) and gastrointestinal bleeding (3.6% and 4.3%, p=0.86).
PCI with coronary artery stenting, prior to coronary bypass surgery, does not affect the frequency of post-operative hospital cardiovascular and hemorrhagic complications.
评估在冠状动脉搭桥手术前行经皮冠状动脉介入治疗（PCI）并置入动脉支架的稳定型心绞痛患者组，以及既往未进行过心肌血运重建的患者组中，医院心血管事件的发生频率。
对120例行常规冠状动脉搭桥手术的稳定型心绞痛患者进行检查。分组情况：男性占80.8%，年龄58±7.6岁，冠心病病程65.7年，有心肌梗死（MI）病史的占77.5%。92.5%的患者存在动脉高血压，12.5%的患者患有糖尿病。72.5%的患者有多支冠状动脉疾病。28例（23.4%）患者既往曾行冠状动脉支架置入PCI。从PCI到冠状动脉搭桥手术的时间为20±32.6个月。88.3%的患者在体外循环下进行冠状动脉搭桥手术，11.7%的患者在非体外循环下进行冠状动脉搭桥手术。远端吻合口数量为1至4个。
在冠状动脉搭桥手术前行PCI或未行PCI的患者组之间，临床和血管造影指标、药物治疗及手术特征均无差异。在分析的患者组中，心脏死亡频率（0和1.1%，p = 0.58）、非致命性MI（3.6%和9.8%，p = 0.29）、中风（0和1.1%，p = 0.58）、急性心力衰竭（11.7%和34.8%，p = 0.06）、阵发性房颤患者数量（28.6%和17.4%，p = 0.94）、再次开胸手术患者比例（3.6%和3.3%，p = 0.94）以及胃肠道出血（3.6%和4.3%，p = 0.86）均无差异。
冠状动脉搭桥手术前行冠状动脉支架置入PCI，不影响术后医院心血管和出血并发症的发生频率。
