Portrait of the patient with myocardial infarction over a 30-year period.

Garganeeva, A. A.; Тукиш, О. В.; Кужелева, Е. А.; Округин, С. А.; Kuzmichkina, M. A.

doi:10.18821/0023-2149-2018-96-7-641-647

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…операций КШ ежегодно [4]. С увеличением продолжительности жизни пациентов с ИБС возрастает потребность в данном типе вмешательств [5,6]. Вместе с тем встает закономерный вопрос о долгосрочной эффективности хирургической реваскуляризации миокарда и факторах, влияющих на отдаленный прогноз.…”

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Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization

Kaveshnikov

Kuzmichkina

Serebryakova

2023

Racionalʹnaâ farmakoterapiâ v kardiologii

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High mortality from cardiovascular diseases (CVD) requires improved approaches to the treatment of this socially significant pathology. Wide implementation of surgical myocardial revascularization makes it possible to improve significantly both life quality and expectancy in patients with coronary heart disease. The aim of this work was to analyze the literature on the impact of preoperative, operative and postoperative factors on the long-term prognosis after coronary artery bypass grafting (CABG). The review refers to both recent and earlier informative works. The target groups for this article are therapists, cardiologists, rehabilitologists, who work with patients in the short and long term after CABG. Data of Russian and foreign literature show that the long-term prognosis after CABG is largely determined by preoperative factors, in particular – age, set of cardiovascular risk factors (RF) and comorbidity, specifically – severity of coronary and systemic atherosclerosis, incident cardiovascular complications, structural and functional state of the heart. In the aggregate these factors reflect the cumulative effect and further potential of actual cardiovascular RFs, affect longterm risk of adverse events, and determine the therapeutic targets of secondary prevention. Priority of arterial conduits and completeness of revascularization are the main operative factors that determine the course of the long-term period after CABG. Among the postoperative factors, the efficiency of secondary CVD prevention is of paramount importance, in particular – achievement of target RF levels, compensation of cardiac and extracardiac pathology, adherence to the long-term medical therapy, known to improve outcomes based on specific comorbidity. Efficiency of secondary CVD prevention largely depends on patient's health attitudes, the key influence on which beyond attending physician can be provided by participation in rehabilitation programs, teaching patients the meaning and essentials of lifestyle modification and cardiovascular RFs’ control.

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Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization

Kaveshnikov

Kuzmichkina

Serebryakova

2023

Racionalʹnaâ farmakoterapiâ v kardiologii

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Surgical revascularization in women: focus on factors worsening the prognosis

2023

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In recent years, there has been an increase in the number of women undergoing coronary artery bypass grafting (CABG). Although the evidence of gender effects on outcomes is controversial, a number of publications have reported less favorable outcomes of CABG in women. The aim of this paper was to review the literature regarding factors that worsen short- and long-term prognosis in women undergoing surgical myocardial revascularization.Gender differences in early outcomes of CABG are largely explained by gender distribution of baseline clinical characteristics. Women, compared to men, undergo CABG at an older age and have a worse profile of cardiovascular disease (CVD) risk factors (RF), comorbidity burden, structural and functional cardiac pathology, and coronary lesions. In women, complete myocardial revascularization is less frequent than in men, venous shunts are used more frequently, and the left internal mammary artery is less frequently used as a conduit. In addition to the baseline characteristics, higher incidence of perioperative myocardial infarction (MI), higher prevalence of anxiety and depression, lower quality of life and social adaptation after CABG, and lower involvement of women in rehabilitation programs, compared to men, may contribute to a less favorable long-term prognosis after CABG in women.There is a need for more information for physicians about the specifics of CVDs and anatomical and surgical aspects of CABG in women. It is also necessary to raise patients’ awareness of RF correction and to involve them in educational technologies. Recommendations for diagnosis and treatment of CVDs should be developed taking into account gender. Further research is also required to develop and implement sex-specific models for predicting surgical risks. Long-term follow-up is appropriate in women with recent MI and a history of diabetes mellitus. To further improve clinical outcomes of CABG in women, development of approaches that facilitate more complete revascularization and reduce the incidence of perioperative complications, such as MI and pneumonia, is needed. More answers to questions regarding gender differences in long-term outcomes of CABG may be obtained by analyzing further studies involving a larger number of female patients.

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Possibilities of the Complicated Rupture Myocardial Infarction Development Prediction in Young and Middle-Aged Men

Гордиенко

A.S.

Sotnikov

et al. 2022

Mediko-farmacevtičeskij žurnal "Pulʹs"

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Relevance. Myocardial ruptures during myocardial infarction remain one of its most dangerous complications. Aim. To evaluate the features of risk factors for the development of myocardial infarction complicated by rupture in young and middle-aged men for predictive modeling of this complication to improve its prevention. Material and methods. The results of examination and treatment of men aged 19-60 years with myocardial infarction were studied. Patients were divided into two age-comparable groups: I – study group, with myocardial rupture – seven patients; II - control, without it - 558 patients. A comparative analysis of clinical, instrumental and laboratory parameters was performed, as well as an analysis of their influence (Pearson's Chi-square) on the risk of myocardial ruptures. Using binary and stepwise logistic regression, a model for predicting the risk of myocardial rupture was created. Results. The study group differed from the control group in terms of a more severe condition of patients (recurrent extensive lesions with multiple complications), the most significant of which were: electrocardiographic signs of right ventricular enlargement (absolute risk: 21.4%; relative: 27.0; p˂0.0001), the presence of thromboembolism (17.9%; 17.5, respectively; p˂0.0001) and pulmonary edema (9.0%; 44.6; p˂0.0001) among the complications myocardial infarction, history of coronary artery bypass surgery (6.6%; 11.0; р˂0.0001), III and IV severity class of acute heart failure according to T. Killip (12.1%; 21.3; р˂ 0.0001), the presence of asystole (18.8%; 23.5; p˂0.0001) and complete atrioventricular block (15.8%; 19.7; p˂0.0001). Conclusions. These factors were used to build a model for predicting the risk of myocardial rupture with good predictive characteristics, suitable for practical use.

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Portrait of the patient with myocardial infarction over a 30-year period.

Cited by 3 publications

References 10 publications

Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization

Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization

Surgical revascularization in women: focus on factors worsening the prognosis

Possibilities of the Complicated Rupture Myocardial Infarction Development Prediction in Young and Middle-Aged Men

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