Types of recurrent myocardial ischemia after coronary bypass
AbstractThe aim of the study was an analysis of clinical and angiographic characteristics of patients with different forms of myocardial ischemia recurrence after coronary bypass surgery.
Material and methods. All 299 patients, enrolled into survey, underwent coronary and bypass graft angiography after myocardial ischemia clinical recurrence following the isolated coronary bypass grafting. The relationship of clinical form and angiographic results as well as primary surgical tactic was analyzed.
Results. Acute myocardial ischemia (myocardial infarction and unstable angina) was much less common: only 58 cases (19.4%, 95% CI 15.3–24.3). Several predictors significantly increased the chances of the myocardial ischemia recurrence in acute forms: left main coronary artery lesion (OR = 2.5; 95% CI 1.4–4.5), three-vessel occlusive lesion (OR = 2.5; 95% CI 1.3–4.9), bifurcation (OR = 5.0; 95% CI 2.1–11.7) and extended (OR = 3.0; 95% CI 1.7–5.4) lesion, previous coronary stenting (OR = 4.6; 95% CI 2.4–8.8) or dominant coronary artery graft dysfunction (OR = 2.4; 95% CI 1.3–4.5).
Conclusion. Myocardial ischemia clinical recurrence is usually associated with one or several grafts dysfunction. Herewith, the clinical form of this recurrence (acute coronary syndrome or stable angina pectoris) depends on the features of the native coronary arteries lesion, the anamnesis (history of percutaneous coronary intervention) or dominant coronary artery graft condition.
Keywords:myocardial ischemia recurrence; coronary artery bypass grafting; coronary bypass graft angiography
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
Authors’ contribution. The concept and design of the study – Hubulava G.G., Volkov A.M.; collection and processing of the material – Gramatikov D.G., Krivopalov V.A.; statistical processing – Krivopalov V.A.; writing of the text – Lyubimov A.I., Krivopalov V.A.; editing – Hubulava G.G., Volkov A.M., Sizenko V.V.
For citation: Volkov A.M., Gramatikov D.G., Lyubimov A.I., Krivopalov V.A., Sizenko V.V., Khubulava G.G. Types of recurrent myocardial ischemia after coronary bypass. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2023; 11 (3): 23–9. DOI: https://doi.org/10.33029/2309-1908-2023-11-3-23-29 (in Russian)
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