scholarly journals Evaluation of observation of the patients with coronary heart disease after surgical treatment

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Z Bekbergenova ◽  
G Mauletbayeva ◽  
A Umbetzhanova ◽  
G Derbissalina ◽  
V Koikov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Medical Records ◽  
Hypertensive Crisis ◽  
Myocardial Revascularization ◽  
Functional Studies ◽  
Coronary Syndrome ◽  
Leading Position ◽  
Artery Disease ◽  
One Year

Abstract Background To reduce mortality from cardiovascular diseases in Kazakhstan, which occupies the leading position, patients are under observation. To evaluate of patients with coronary artery disease who have undergone myocardial revascularization by installing coronary artery stenting or bypass surgery. Methods A retrospective analysis of outpatient medical records of patients. Results Analysis included medical records of 4% patients at the age of 40-49 years, 49%-50-59 years, 22%-60-69 years, 11%-70-79 years, 4% patients older than 80 year. 92% patients were admitted to the hospital with acute coronary syndrome and were urgently operated. Patients with chronic heart failure were operated routinely. 12% patients received surgical treatment twice, including 4% patients routinely. All patients had comorbidities: 63% of people-arterial hypertension, 12%-cardiac arrhythmia, 14%-diabetes. The analysis showed that only 51% of patients were regularly observed in accordance with the standards of the survey during one year of observation. According to the standards the scheduled ECG study of the patients after surgery should be done after 1, 2, 3 and 6 months. In accordance of the standard 23% patients were examined, 3 times a year - 19% patients, 23% people-twice a year. Other functional studies-echocardiography 1 time per year have been studied on 14% people, treadmill test-5% patients. Coagulation monitoring during one year- 46% patients. One of the criteria of proper observation is the number of readmissions. 11% patients were readmitted where 5% of them in the first month after surgery-6% patient with hypertensive crisis, 11%-with an increase of CHF, 2%-with postoperative pleural effusion. 2% patients hospitalized with restenosis after 7 months. Conclusions It should be noted that irregular visits to the doctor questioned the compliance of patients to treatment. Due to the lack of control by medical workers, the patients were not fully examined. Key messages The continuity of work between hospital doctors and primary care organizations is necessary. Patients to improve the favorable prognosis requires regular medication.

scholarly journals Rationale for revascularization to improve prognosis in stable coronary artery disease: the data from ISCHEMIA trial

2020 ◽  
Vol 25 (8) ◽  
pp. 3819
Author(s):  
L. L. Bershtein ◽  
E. V. Zbyshevskaya ◽  
V. E. Gumerova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Coronary Artery Disease ◽  
Myocardial Revascularization ◽  
Medical Interventions ◽  
Coronary Syndrome ◽  
Artery Disease

Although myocardial revascularization is one of the most studied types of medical interventions, there is a heated discussion in cardiology about the feasibility and indications for it in patients with stable coronary artery disease (chronic coronary syndrome). The recently completed ISCHEMIA trial is the largest current study comparing conservative versus invasive strategies in this category of patients. The article discusses the rationale for revascularization to improve prognosis according to the ISCHEMIA trial.

scholarly journals Smoking Cessation after Myocardial Revascularization Procedures

2014 ◽  
Vol 11 (3) ◽  
pp. 150-153
Author(s):  
Thiago Gonçalves Schroder e Souza ◽  
Jonathan Batista Souza ◽  
Evandro Bertanha Nunes ◽  
Roberto Mário Arruda Verzola ◽  
Cláudia Vanessa Barrionuevo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Artery Disease ◽  
One Year ◽  
Revascularization Procedures

Introduction: Smoking is associated with the development of coronary artery disease and influences negatively the prognosis of patients undergoing myocardial revascularization procedures. However, the rate of smoking cessation after these procedures is not well established in the literature. We aimed to evaluate the rate of smoking cessation in patients undergoing revascularization procedures, immediately and after 12 months of follow-up.Methods: We examined smoking patients from a unique cardiology center who underwent myocardial revascularization procedures between January 2010 and December 2011. These patients were allocated to two groups according to the revascularization procedure performed: Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Interventions (PCI). Data related to cessation or maintenance of smoking were obtained at subsequent clinical appointments or telephone calls.Results: Among 173 patients selected, 118 (68.2%) underwent PCI and 55 (31.8%) underwent CABG. After revascularization procedures, the total rate of smoking cessation was 79.3%. Furthermore, there was no significant difference between the two groups (83.6% – CI 95%: 71.2–92.2% for CABG, and 79.3% – CI 95%: 70.8–86.3% for PCI). The maintenance of smoking cessation after one year was 53.2%, similar between groups (52.7% for CABG and 53.4% for PCI). Nevertheless, the average time of smoking cessation was significantly higher in the CABG group (6.9 months versus 4.5 months for PCI).Conclusions: Coronary interventions add important value to smoking cessation, and the smoking cessation rates were similar, independent of the procedure executed.

scholarly journals Is there a place for a multidisciplinary “Heart Team” approach to the selection of myocardial revascularization method in patients with acute coronary syndromes?

2021 ◽  
Vol 26 (2) ◽  
pp. 4210
Author(s):  
O. L. Barbarash ◽  
V. I. Ganyukov ◽  
R. S. Tarasov ◽  
L. S. Barbarash
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Team Approach ◽  
Heart Team ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Artery Disease ◽  
Selection Of

Current review article, based on foreign and Russian studies, guidelines of the European and North American cardiological and surgical communities, summarizes the expert positions on the place of multidisciplinary “Heart Team” approach in the selection of management strategy for patients with various types of coronary artery disease. The positions of modern clinical guidelines regarding percutaneous coronary intervention and coronary artery bypass grafting in acute coronary syndrome are given. Prospective positions for optimizing the decisionmaking process by a multidisciplinary team when considering difficult patients are presented.

scholarly journals Comorbidities in Patients before Surgical Myocardial Revascularization: Current State of the Problem. Part I

2021 ◽  
pp. 10-17
Author(s):  
Olena K. Gogayeva ◽  
Mariia A. Drobnich ◽  
Natalia O. Lytvyn ◽  
Oleksandra O. Nastenko ◽  
Roman I. Salo
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Chronic Kidney Disease ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Kidney Disease ◽  
Myocardial Revascularization ◽  
Comorbidity Index ◽  
Artery Disease

Every year we see an increase in the number of patients with indications for surgical treatment of coronary artery disease. In addition to the difficulties of the cardiac surgery process, no less important is the therapeutic support of patients, which in addition to cardiac subtleties requires guidance in concomitant nosologies. As the age of patients increases, there is a higher comorbidity which is associated with difficult management of patients, extensive prescription of drugs and higher cost of medical care. The aim. To analyze the current literature data on comorbidity in patients hospitalized for coronary artery bypass grafting. Results. According to the literature data, there is a high Charlson comorbidity index, in average 5.7 ± 1.7, in the baseline status of patients with coronary artery disease. High comorbidity index is known for its negative effect on the functioning of grafts in the long-term period after surgical myocardial revascularization. Among patients who underwent surgical revascularization of the myocardium, 22.8–46.9% had diabetes mellitus, 37.5% had obesity, 1.1% had rheumatoid arthritis and 10–12% suffered from chronic kidney disease. There is no statistical data on preoperative status of gastrointestinal tract, but the main complications and predictors of death were identified. Due to the increase in the occurrence of autoimmune diseases on the background of the COVID-19 pandemic, an increase in the number patients with connective tissue diseases in cardiac surgery is predicted, and perioperative management of such patients has its own characteristics and requires further in-depth study. Conclusions. Searching for comorbidity in cardiac surgery patients with coronary artery disease is an important component of their preoperative preparation and risk stratification. The influence of type 2 diabetes mellitus, obesity, autoimmune diseases, chronic kidney disease on the occurrence of postoperative complications and the result of surgical myocardial revascularization has been proven. SARS-CoV-2 infection in the surgical treatment of coronary artery disease is another challenge of today that requires further observation and research to help address prognosis, complications, and mortality.

DIRECT RESULTS OF CORONARY BYPASS GRAFTING OF PATIENTS WITH THE REDUCED MYOCARDIAL CONTRACTILITY IN TERMS OF MYOCARDIAL PERFUSION SCINTIGRAPHY AND ECHOCARDIOGRAPHY

2021 ◽  
pp. 5-9
Author(s):  
Abrol Mansurov
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Surgical Treatment ◽  
Myocardial Perfusion ◽  
Myocardial Perfusion Scintigraphy ◽  
Stress Test ◽  
Myocardial Revascularization ◽  
Early Postoperative Period ◽  
Perfusion Scintigraphy ◽  
Artery Disease

This article provides an analysis of the results of surgical treatment of patients with various forms of coronary artery disease, the study of the quality and reliability of myocardial revascularization, assessment of patency and functional viability of coronary grafts in the early postoperative period using echocardiography and myocardial perfusion scintigraphy. The retrospective material of our study is based on the results of surgical treatment of 130 patients with coronary artery disease who were operated on in the IHD department over the past year. All patients underwent examination according to a standard protocol: electrocardiography, 24-hour Holter monitoring, selective coronary ventriculography and shuntography, echocardiography, perfusion scintigraphy before and after surgery, drug stress test to assess myocardial perfusion and contractility and its differentiation (ischemia, scarring) with hypoperfusion.

Single-center register of myocardial revascularization in patients with coronary artery disease and acute coronary syndrome in the context of COVID-19 pandemic

2021 ◽  
Vol 20 (6) ◽  
pp. 2876
Author(s):  
O. V. Kamenskaya ◽  
A. S. Klinkova ◽  
I. Yu. Loginova ◽  
V. N. Lomivorotov ◽  
A. M. Chernyavskiy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Syndrome ◽  
Short And Long Term ◽  
Artery Disease

Aim. To assess the short- and long-term outcomes of myocardial re- vascularization (MR) in patients with coronary artery disease (CAD) and acute coronary syndrome (ACS) in the context of coronavirus disease 2019 (COVID-19) pandemic.Material and methods. In the period from April to August 2020, 550 patients with CAD and ACS were included in the register. Emergency percutaneous transluminal coronary angioplasty (n=499) and on-pump coronary artery bypass grafting (CABG) (n=51) were performed. The follow-up period lasted 6 months. The pattern of complications after MR and effects of COVID-19 were analyzed.Results. The studied cohort is represented by patients with CAD >65 years old. ST segment elevation ACS was detected in 23%, acute myocardial infarction — in 59,1%, in other cases — unstable angina. During hospitalization after MR, atrial fibrillation prevailed among cardiovascular complications (4,7%). During this period, 29 (5,3%) patients was diagnosed with COVID-19. In the short-term period after MR, 3 (0,5%) people died due to COVID-19 complications-. In the long-term period after MR, 4 (0,7%) cases of non-fatal stroke were registered, while repeated MR — in 7,1%. The all-cause mortality rate was 1,3% (n=7), of which 57,1% of patients died due to COVID-19 complications. In the subgroup of patients who underwent CABG, the greatest number of in-hospital complications was noted, where exudative pleurisy, atrial fibrillation and anemia prevailed. Of the patients with COVID-19, pneumonia in the short-and long-term posto perative periods was recorded in 48,3 and 61,3%, respectively. Pneumonia is associated with respiratory failure, cardiac dysfunction, and anemia. The risk of COVID-19 pneumonia during the entire follow-up period was higher in patients with ACS who underwent CABG (odds ratio, 19,4; confidence interval: 13,3-26,1; p<0,001). The overall survival rate was 98,7%.Conclusion. COVID-19 infection in patients with ACS after MR effects pattern of postoperative complications. The proportion of COVID-19 pneumonia in patients with ACS in hospital, short-  and long-term postoperative periods after MR significantly exceeds that in the general population. The leading factor associated with COVID-19 pneumonia in patients with ACS is on-pump CABG.

scholarly journals Dyslipidemia Management in Patients with Coronary Artery Disease. Data from the POLASPIRE Survey

2021 ◽  
Vol 10 (16) ◽  
pp. 3711
Author(s):  
Piotr Jankowski ◽  
Paweł Kozieł ◽  
Małgorzata Setny ◽  
Marlena Paniczko ◽  
Maciej Haberka ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Revascularization ◽  
Lipid Lowering ◽  
Professional Activity ◽  
High Dose ◽  
Lipid Lowering Therapy ◽  
Related Factors ◽  
Coronary Syndrome ◽  
Artery Disease

Lipid-lowering in patients with coronary artery disease (CAD) is related to a lower risk of cardiovascular events. We evaluated factors related to the management of hypercholesterolemia in patients with established CAD. Patients were interviewed 6–18 months after hospitalization for an acute coronary syndrome (ACS) or a myocardial revascularization procedure. Statins were prescribed at discharge to 94.4% of patients, while 68.1% of the patients hospitalized for an ACS were prescribed a high-dose statin. Hospitalization in a teaching hospital, percutaneous coronary intervention, cholesterol measurement during hospitalization and the male sex were related to prescription of statins at discharge. The intensity of lipid-lowering therapy in the post-discharge period increased in 17.3%, decreased in 11.7%, and did not change in 71.0% of the patients. The prescription of a lipid-lowering drug (LLD) at discharge (odds ratio 5.88 [95% confidence intervals 3.05–11.34]) and a consultation with a cardiologist (2.48[1.51–4.08]) were related to the use of LLDs, while age (1.32 [1.10–1.59] per 10 years), loneliness (0.42[0.19–0.94]), professional activity (1.56[1.13–2.16]), and diabetes (1.66[1.27–2.16]) were related to achieving an LDL cholesterol goal 6–18 months after discharge. In conclusion, health-system-related factors are associated with the LLD utilization, whereas mainly patient-related factors are related to the control of hypercholesterolemia following hospitalization for CAD.

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