Clinical Characteristics of Patients Under Routine Sedation in Endovascular Treatment of Ischemic Heart Disease

Abstract

In Ukraine, the number of emergency and elective coronary artery stenting operation is steadily growing from year to year, for instance, the number of the operations doubled for the period of 2014 – 2017. We carried out a retrospective study at the Heart Institute of the Ministry of Health of Ukraine in 2017 – 2018. The medical records of 73 patients (58 men and 15 women) aged 35 – 83 who underwent coronary angiography and emergency and elective coronary artery stenting were selected for the study. Surgical interventions were performed under routine sedation (sedation level II-III according to the Ramsay Sedation Score) with diazepam and / or fentanyl and / or morphine.
 The aim of the study was to characterize the main clinical characteristics of patients with different forms of coronary artery disease who underwent X-ray image-guided endovascular treatment under different modes of routine anesthesia. We have found out overweight men aged 59.93 ± 0.84 prevailed among the patients under the study. We selected patients with different clinical forms of coronary heart disease including acute coronary syndrome (myocardial infarction, unstable angina) and chronic coronary syndromes (angina pectoris of different functional classes, asymptomatic coronary artery atherosclerosis). 29 (39.73%) patients underwent coronary angiography and elective coronary artery stenting; 44 patients (60.27%) had diagnostic coronary angiography and emergence stenting operations. The main comorbidities on admission to the hospital were as follows: 64 patients were diagnosed as having hypertension of various stages and degrees (87.67%); nine patients (13.71%) had diabetes, including 1.37% of newly diagnosed diabetics. Atrial fibrillation was found in 12.33% of the patients. Hyperglycemia at the admission to the hospital was detected in 25 patients that made up a third of all patients (34.25%). Among the patients, who had elected operations, the overwhelming indication for stenting was exertional angina, FC III (21.92%); among the patients who underwent emergency operations, the key indications was myocardial infarction with ST segment elevation (38.36%). In the group of the patients who were admitted for emergency hospitalization, fentanyl was mainly used for intraoperative sedation, while fentanyl and diazepam were used for the patients, who had elective surgeries.