COMPARATIVE RESULTS OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH LEFT MAIN AND MULTIVSSEL CORONARY ARTERY DISEASE. LITERATURE REVIEW.
Introduction: Cardiovascular diseases and, in particular, coronary artery disease (CAD) are the leading causes of death worldwide. In recent decades, great progress has been made in reducing mortality from CAD. Along with the development and improvement of medical therapy (MT), the emergence of methods of coronary revascularization, namely coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), has become one of the main advances in medicine over the past century. After decades of continuous development, both procedures have become traditional treatments for coronary artery disease, and the effects of these types of coronary revascularization on the long-term survival of patients with CAD has become a subject of ongoing debate.
Aim: to analyze the published results of randomized clinical trials comparing the outcomes of CABG and PCI, and to evaluate the long-term consequences of each revascularization strategy for the patient.
Search strategy: The search for sources was conducted in the databases Medline, Pubmed, Scopus and The Сochrane Library. The search depth was 10 years from 2010 to 2021, excluding historical documents. During the search, 75 sources were selected and analyzed.
Results: An analysis was made of the results of eight randomized controlled trials and five meta-analysis comparing the outcomes of CABG and PCI over the past 10 years. The criteria for evaluating the effectiveness of the selected strategies were combined endpoints of studies, such as the development of death, stroke, myocardial infarction and / or target-vessel revascularization.
Conclusions: For a patient with multivessel coronary artery disease, CABG is associated with better survival rates compared to long-term results of PCI. At the same time, PCI is a reasonable alternative to CABG for the patients with lesions of one or two vessels without the proximal LAD disease. In addition, PCI has not worse results in comparison with CABG in patients with left main disease. Despite the reports on the best results of CABG in the analyzed studies, the choice of one or another type of revascularization is still a controversial issue and requires further comprehensive study.
Maira I. Madieva1, Marat A. Aripov2, Aleksei Yu. Goncharov2
1 Pavlodar branch of the NCJSC "Semey Medical University", Pavlodar, Republic of Kazakhstan;
2 National Scientific Cardiac Surgery Center, Nur-Sultan, Republic of Kazakhstan.
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Madieva M.I., Aripov M.A., Goncharov A.Yu. Comparative results of myocardial revascularization in patients with left main and multivssei coronary artery disease. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 3, pp. 127-140 doi 10.34689/SH.2022.24.3.016Related publications:
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