Comparison of surgical and endovascular strategies for revascularization of the myocardium in patients with ischemic heart disease and multivessel coronary artery disease with prior stenting of clinical-related artery in acute coronary syndrome with ST-segment elevation according to the results of two years observation

Bocharov A.V. ¹, Popov L.V.²

Objective: analysis of two-year results of observations of two groups of patients who initially successfully underwent percutaneous coronary intervention of clinical-dependent artery using stents of the 3rd generation with drug coating for acute coronary syndrome with St segment elevation, and then performed complete functional myocardial revascularization by coronary artery bypass grafting or stenting also using stents of the third generation with drug coating.

Materials and methods: the total sample of the study consisted of 110 patients with coronary artery disease and multivessel coronary artery disease the coronary arteries who were performed emergency stenting clinical-related artery in acute coronary syndrome with ST-segment elevation, and subsequently a complete functional revascularization not later than 90 days from the date of completion of the first phase. Complete functional revascularization was performed by methods of coronary artery bypass grafting or stenting with the use of stents 3-generation drug-eluting and biodegradable polymer. Patients of both groups were followed up after complete revascularization on a quarterly basis on an outpatient basis for 2 years. The end points of observation in both groups were cardiovascular mortality, myocardial infarction, acute cerebrovascular accident, repeated revascularization and combined macce end point (cardiovascular mortality, myocardial infarction, acute cerebrovascular accident, repeated revascularization).

Results: there were no statistically significant differences between the groups in clinical, demographic and operational characteristics, except for the frequency of a history of myocardial infarction, which was significantly more common in the group of coronary artery bypass grafting. The analysis of the results revealed significant differences between the groups in the frequencies of revascularization and, accordingly, the combined macce point, which were significantly higher in the stenting group.

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