| Autor: |
Sumin AN; Federal State Budgetary Scientific Institution 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo 650002, Russia., Shcheglova AV; Federal State Budgetary Scientific Institution 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo 650002, Russia., Adyakova OV; Federal State Budgetary Scientific Institution 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo 650002, Russia., Fedorova DN; Federal State Budgetary Scientific Institution 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo 650002, Russia., Yakovlev DD; Federal State Budgetary Educational Institution of Higher Education 'Kemerovo State Medical University' of the Ministry of Health of the Russian Federation, Kemerovo 650056, Russia., Svinolupova NA; Federal State Budgetary Educational Institution of Higher Education 'Kemerovo State Medical University' of the Ministry of Health of the Russian Federation, Kemerovo 650056, Russia., Kabanova SV; Federal State Budgetary Educational Institution of Higher Education 'Kemerovo State Medical University' of the Ministry of Health of the Russian Federation, Kemerovo 650056, Russia., Malysheva AV; Federal State Budgetary Educational Institution of Higher Education 'Kemerovo State Medical University' of the Ministry of Health of the Russian Federation, Kemerovo 650056, Russia., Karachenko MY; Federal State Budgetary Educational Institution of Higher Education 'Kemerovo State Medical University' of the Ministry of Health of the Russian Federation, Kemerovo 650056, Russia., Kashtalap VV; Federal State Budgetary Scientific Institution 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo 650002, Russia., Barbarash OL; Federal State Budgetary Scientific Institution 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo 650002, Russia. |
| Abstrakt: |
The aim : to evaluate the incidence of obstructive lesions of the coronary arteries during routine coronary angiography (CAG) before carotid endarterectomy (CEA) and the incidence of perioperative complications. Materials and Methods : We examined a continuous sample of 498 patients before CEA who underwent an invasive evaluation of the coronary bed during CAG. Depending on the hemodynamic significance of coronary artery lesions, the patients were divided into three groups: group I-obstructive coronary artery disease (≥70%) ( n = 309, 62.0%); group II-non-obstructive lesions of the coronary arteries (<70%) ( n = 118, 23.7%); group III-intact coronary arteries ( n = 71, 14.3%). The groups were compared with each other according to the data of the preoperative examination (clinical and anamnestic parameters, laboratory data and results of echocardiography), as well as according to the immediate results of the operation. In the hospital period, adverse cardiovascular events were assessed: death, myocardial infarction (MI), stroke, arrhythmias, atrial fibrillation or flutter (AF/AFL) and combined endpoint. Results : The groups differed significantly in the presence of symptoms of angina pectoris, myocardial infarction and myocardial revascularization procedures in their medical history and in the presence of chronic ischemia of the lower extremities. However, in the group of intact coronary arteries, the symptoms of angina were in 14.1% of patients, and a history of myocardial infarction was in 12.7%. Myocardial revascularization before CEA or simultaneously with it was performed in 43.0% of patients. As a result, it was possible to reduce the number of perioperative cardiac complications (mortality 0.7%, perioperative myocardial infarction 1.96%). Conclusions : The high incidence of obstructive lesions in the coronary arteries in our patients and the minimum number of perioperative complications favor routine CAG before CEA. |
