Predictors of Long-Term Outcomes after Surgical Myocardial Revascularization br

被引:0
|
作者
Kaveshnikov, V. S. [1 ]
Kuzmichkina, M. A. [1 ]
Serebryakova, V. N. [1 ]
机构
[1] Russian Acad Sci, Tomsk Natl Res Med Ctr, Cardiol Res Inst, Tomsk, Russia
关键词
coronary artery bypass grafting; surgical revascularization; predictors; risk factors; long-term prognosis; comorbidity; secondary prevention; INTERNAL-THORACIC-ARTERY; BYPASS GRAFT-SURGERY; FOLLOW-UP; INCOMPLETE REVASCULARIZATION; CORONARY; SURVIVAL; DISEASE; VEIN; METAANALYSIS; VALIDATION;
D O I
10.20996/1819-6446-2022-12-09
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
High mortality from cardiovascular diseases (CVD) requires improved approaches to the treatment of this socially significant pathology. Wide imple-mentation of surgical myocardial revascularization makes it possible to improve significantly both life quality and expectancy in patients with coronaryheart disease. The aim of this work was to analyze the literature on the impact of preoperative, operative and postoperative factors on the long-termprognosis after coronary artery bypass grafting (CABG). The review refers to both recent and earlier informative works. The target groups for thisarticle are therapists, cardiologists, rehabilitologists, who work with patients in the short and long term after CABG. Data of Russian and foreignliterature show that the long-term prognosis after CABG is largely determined by preoperative factors, in particular - age, set of cardiovascular riskfactors (RF) and comorbidity, specifically - severity of coronary and systemic atherosclerosis, incident cardiovascular complications, structural andfunctional state of the heart. In the aggregate these factors reflect the cumulative effect and further potential of actual cardiovascular RFs, affect long-term risk of adverse events, and determine the therapeutic targets of secondary prevention. Priority of arterial conduits and completeness of revascu-larization are the main operative factors that determine the course of the long-term period after CABG. Among the postoperative factors, the efficiencyof secondary CVD prevention is of paramount importance, in particular - achievement of target RF levels, compensation of cardiac and extracardiacpathology, adherence to the long-term medical therapy, known to improve outcomes based on specific comorbidity. Efficiency of secondary CVD pre-vention largely depends on patient's health attitudes, the key influence on which beyond attending physician can be provided by participation in reha-bilitation programs, teaching patients the meaning and essentials of lifestyle modification and cardiovascular RFs' control
引用
收藏
页码:710 / 716
页数:7
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