Authors
Grebennik V.K., Kucherenko V.S., Hunda F., Gordeev M.L.
Federal State Budgetary Institution “Almazov National Medical Research Centre” of the Ministry of Health of the Russian Federation.
Abstract
Objective: based on the identified predictors of recurrence of angina create a system of forecasting the return of angina after coronary bypass surgery.
Material and Methods: The study included 255 patients who between 2005 and 2017 who performed CABG. 163 patient study group at different times after the operation had angina recurrence. The median time to recurrence was 34,9 ± 41,3 months. The comparison group included 92 people without clinical angina after coronary bypass surgery.
Results: When univariate correlation analysis of the causes of recurrent angina correlation at the level of expressed (r˃0,6) was observed in the following factors: smoking, number of previous MI, diabetes, high cholesterol, lack of statin therapy, generalized atherosclerosis. From operating factors should be highlighted: the number of grafts used, perioperative myocardial infarction and development of low cardiac output syndrome, these factors, the correlation coefficient was at moderate. Multivariate discriminant analysis identified the most significant predictors of return angina statin therapy, type of cardioplegia, incomplete revascularization, BMI, number of grafts, time of anoxia, the development of low cardiac output syndrome. The constructed model of the discriminant function was classified by 92% of the patients, thus practically all patients were fit in the model.
Conclusions: The most significant predictors of angina recurrence are: inadequate statin therapy, body mass index, the number of grafts used, incomplete myocardial revascularization, the type of cardioplegia, development of low cardiac output, the time of anoxia.
Keywords: Grebennik V.K., Kucherenko V.S., Hunda F., Gordeev M.L.
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