Sumin Alexey N, Shcheglova Anna V, Adyakova Olesya V, Fedorova Darina N, Yakovlev Denis D, Svinolupova Natalia A, Kabanova Svetlana V, Malysheva Anastasia V, Karachenko Marina Yu, Kashtalap Vasily V, Barbarash Olga L
Federal State Budgetary Scientific Institution "Research Institute of Complex Problems of Cardiovascular Diseases", Kemerovo 650002, Russia.
Federal State Budgetary Educational Institution of Higher Education "Kemerovo State Medical University" of the Ministry of Health of the Russian Federation, Kemerovo 650056, Russia.
J Clin Med. 2024 Sep 17;13(18):5495. doi: 10.3390/jcm13185495.
: to evaluate the incidence of obstructive lesions of the coronary arteries during routine coronary angiography (CAG) before carotid endarterectomy (CEA) and the incidence of perioperative complications. : We examined a continuous sample of 498 patients before CEA who underwent an invasive evaluation of the coronary bed during CAG. Depending on the hemodynamic significance of coronary artery lesions, the patients were divided into three groups: group I-obstructive coronary artery disease (≥70%) ( = 309, 62.0%); group II-non-obstructive lesions of the coronary arteries (<70%) ( = 118, 23.7%); group III-intact coronary arteries ( = 71, 14.3%). The groups were compared with each other according to the data of the preoperative examination (clinical and anamnestic parameters, laboratory data and results of echocardiography), as well as according to the immediate results of the operation. In the hospital period, adverse cardiovascular events were assessed: death, myocardial infarction (MI), stroke, arrhythmias, atrial fibrillation or flutter (AF/AFL) and combined endpoint. : The groups differed significantly in the presence of symptoms of angina pectoris, myocardial infarction and myocardial revascularization procedures in their medical history and in the presence of chronic ischemia of the lower extremities. However, in the group of intact coronary arteries, the symptoms of angina were in 14.1% of patients, and a history of myocardial infarction was in 12.7%. Myocardial revascularization before CEA or simultaneously with it was performed in 43.0% of patients. As a result, it was possible to reduce the number of perioperative cardiac complications (mortality 0.7%, perioperative myocardial infarction 1.96%). : The high incidence of obstructive lesions in the coronary arteries in our patients and the minimum number of perioperative complications favor routine CAG before CEA.
评估在颈动脉内膜切除术(CEA)前常规冠状动脉造影(CAG)期间冠状动脉阻塞性病变的发生率以及围手术期并发症的发生率。我们检查了498例CEA术前接受CAG期间冠状动脉床侵入性评估的连续样本患者。根据冠状动脉病变的血流动力学意义,将患者分为三组:第一组——阻塞性冠状动脉疾病(≥70%)(n = 309,62.0%);第二组——冠状动脉非阻塞性病变(<70%)(n = 118,23.7%);第三组——冠状动脉正常(n = 71,14.3%)。根据术前检查数据(临床和既往史参数、实验室数据及超声心动图结果)以及手术即时结果对各组进行相互比较。在住院期间,评估不良心血管事件:死亡、心肌梗死(MI)、中风、心律失常、心房颤动或扑动(AF/AFL)以及复合终点。各组在心绞痛症状、心肌梗死病史、心肌血运重建手术史以及下肢慢性缺血情况方面存在显著差异。然而,在冠状动脉正常组中,14.1%的患者有胸痛症状,12.7%的患者有心肌梗死病史。43.0%的患者在CEA前或同时进行了心肌血运重建。结果,围手术期心脏并发症数量得以减少(死亡率0.7%,围手术期心肌梗死1.96%)。我们患者中冠状动脉阻塞性病变的高发生率以及围手术期并发症的最少数量支持在CEA前进行常规CAG。