Publication Details
Abstract
Objective: To identify clinical predictors of coronary heart disease with assessment of nosological structures by frequency of multivessel coronary artery disease in gender-age aspects in patients after CABG.
Material and methods: The study was conducted at the "American Hospital" clinic in Tashkent. A cross-sectional retrospective study was conducted, which included 234 patients (81.6% men, 18.3% women, mean age 61.5 ± 5.1 years) who underwent elective coronary artery bypass grafting (CABG) in 2022. Inclusion criteria were: confirmed diagnosis of coronary heart disease (CHD), indications for elective CABG, and a complete set of clinical and instrumental data. Nonparametric statistical methods were applied for analysis using SPSS 26.0 and R 4.0.2 programs.
Results: According to the study results, patients in the 60-69 age group demonstrated the highest frequency of multivessel disease (45.7% of cases), with this category of patients predominantly receiving 3-4 grafts. History of arterial hypertension was recorded in 98.3%, diabetes mellitus in 32.4% of patients, serving as concomitant and competing diseases in all operated patient groups. Most patients were operated on for exertional angina, with the majority having Class III exertional angina, comprising 53.8% without a history of AMI. The average number of grafts placed was 3.1±1.0 and 3.3±0.9, with nearly 2/3 of operated patients (63.2%) receiving 3 vessel grafts, 21.3% - 2 vessels, 3% - 1 vessel, and 12.4% underwent placement of 4 vessel grafts. Among these, the highest frequency of multivessel disease was associated with AMI: 70% (3 vessels), ACS: 66.6%, exertional angina: 59.7%. Diabetes mellitus: 68.4%, PIMI: 52.9%.
Conclusions: The obtained data indicate an age-dependent character of multivessel coronary lesions with maximum expression in patients aged 60-69 years. Key clinical predictors were identified (AMI, type 2 diabetes, hypertension) that require special attention when planning revascularization in patients over 60 years. The study results emphasize the need for a differentiated approach to patient selection for CABG, taking into account age characteristics and comorbid background.
Practical significance: The results help optimize patient selection for CABG, individualize approach and minimize risk of complications and improve long-term outcomes.