actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.12737/article_59a614f8afcde0.78457348actabiomedica-615Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEНЕПОЛНАЯ КОРОНАРНАЯ РЕВАСКУЛЯРИЗАЦИЯ КАК НЕЗАВИСИМЫЙ ФАКТОР РИСКА УХУДШЕНИЯ ПРОГНОЗА КОРОНАРНОГО ШУНТИРОВАНИЯ БЕЗ ИСКУССТВЕННОГО КРОВООБРАЩЕНИЯ У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦАINCOMPLETE CORONARY REVASCULARIZATION AS AN INDEPENDENT RISK FACTOR OF OFF-PUMP CORONARY ARTERY BYPASS GRAFTING PROGNOSIS IN PATIENTS WITH ISCHEMIC HEART DISEASEПодкаменныйВ. А.PodkamenniyV. A.pvdm@inbox.ruЛихандиД. И.LikhandiD. I.likhandi_di@mail.ruЖелтовскийЮ. В.ZheltovskyY. V.noemail@neicon.ruШаравинА. А.SharavinA. A.noemail@neicon.ruВырупаевА. В.VyrupaevA. V.noemail@neicon.ruИркутская государственная медицинская академия последипломного образования -филиал ФГБОУ «Российская медицинская академия непрерывного профессионального образования» Минздрава России; ГБУЗ «Иркутская ордена «Знак почёта» областная клиническая больница»Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education; Irkutsk Regional Clinical HospitalГБУЗ «Иркутская ордена «Знак почёта» областная клиническая больница»Irkutsk Regional Clinical HospitalИркутская государственная медицинская академия последипломного образования -филиал ФГБОУ «Российская медицинская академия непрерывного профессионального образования» Минздрава России; ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава России; ГБУЗ «Иркутская ордена «Знак почёта» областная клиническая больница»Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical University; Irkutsk Regional Clinical Hospital201728042017224044Copyright © Подкаменный В.А., Лиханди Д.И., Желтовский Ю.В., Шаравин А.А., Вырупаев А.В., 20172017Подкаменный В.А., Лиханди Д.И., Желтовский Ю.В., Шаравин А.А., Вырупаев А.В.Podkamenniy V.A., Likhandi D.I., Zheltovsky Y.V., Sharavin A.A., Vyrupaev A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/615

Обследованы 1418 больных ишемической болезнью сердца, оперированных в период с 2001 по 2014 гг. Из них у 469 была выполнена неполная коронарная реваскуляризация (НКР), у остальных (n = 949) - полная коронарная реваскуляризация (ПКР). В ходе сравнительной оценки отдалённые результаты операций с ПКР и НКР оценивались по количеству и времени наступления больших кардиальных событий и выживаемости. Выживаемость и свобода от больших кардиальных событий были статистически значимо выше у больных после ПКР, т. е. доказана роль НКР как независимого фактора риска ухудшения отдалённых результатов коронарного шунтирования.

Currently, most researchers define the term complete coronary revascularization (CCR) as coronary arterial bypass graft (CABG) of at least one branch of each of the three affected coronary basins: left anterior descending artery (LAD) left circumflex artery (LCA) and right coronary artery RCA. The rejection of bypass of one or more diseased coronary basin is estimated as an incomplete coronary revascularization (ICR). Material and methods. This retrospective study included patients, underwent isolated coronary bypass operations from 2001 to 2014 in the Irkutsk Regional Hospital. 1418 patients underwent isolated off-pump bypass operations. ICR occurred in 469 patients, the CCR - in 949. All patients were divided into 2 groups: ICR group and CCR group. These groups were compared by the late survival and by the frequency of the major cardiac events (MACE). The results of study were assessed after 1, 5 and 10 years from the date of CABG. Results. Survival of patients of ICR group after 1,5,10 years after surgery was 98.5 %, 75.4 % and 75.4 % respectively, of CCR group of patients - 98.7 %, 88.7 % and 81.3 % (p = 0.006). In ICR group "free" from MACE after 1, 5 and 10 years after surgery were respectively 98.2 %, 70.8 % and 61.0 % of patients, while in CCR group those made 98.3 %, 84.6 % and 72,6 % (p = 0,007). We can conclude that incomplete revascularization can be defined as a prediction factor of worst long-term outcome results of CABG.

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The authors declare that there are no conflicts of interest present.