ОPTIMIZATION OF FOLLOW-UP OF ELDERLY PATIENTS WITH CORONARY HEART DISEASE WHO RECEIVED A COMPREHENSIVE CARDIO REHABILITATION PROGRAM AFTER PERFORMING CORONARY ARTERY BYPASS SURGERY
Relevance: Surgical myocardial revascularization remains the most effective procedure for the treatment of coronary heart disease in elderly patients, as it allows to eliminate the symptoms of the disease, increases long-term survival, and improves patients' quality of life. Coronary bypass surgery grafting (CABG) occupies a leading place in the treatment of coronary heart disease. However, the issues of patients' postoperative quality of life and health condition remain very controversial.
Objective: to analyze long-term results in patients over 65 years of age with coronary artery disease (during the year of follow-up) who received a comprehensive cardiac rehabilitation program after performing coronary artery bypass surgery compared to a group of patients who did not undergo rehabilitation or did not receive it in full capacity.
Materials and methods: a linear single-centered cohort study (on average 12±3 months) was conducted in a general group (n=130) of patients to study the effect of cardio rehabilitation on the quality of life of elderly patients with coronary heart disease who underwent CABG. During the study, most patients took antianginal and antihypertensive medications, aspirin, and statins that were prescribed by the attending physician. Observation of the postoperative course was carried out both by recording changes during repeated visits, and by periodic phone calls. At the same time, the tolerability to everyday physical activity (a 6-minute walking test was performed), blood pressure compensation, dynamic ECG monitoring, and echocardiography with the determination of the changes in the ejection fraction and left ventricular dysfunction, all vascular events, and failures that took place during the observation period were recorded.
Results and conclusions: based on the results of the study, several unfavorable factors were identified in elderly patients after CABG, such as multivessel coronary artery disease, obesity, smoking, chronic heart failure, diabetes mellitus, and uncontrolled hypertension. But one of the main factors is the absence of cardiac rehabilitation. According to the results of observation, after passing all stages of cardio rehabilitation, patients showed a significant improvement in the quality of life, later onset of episodes of angina pectoris and the development of chronic heart failure, as well as a higher adherence of patients to basic therapy for coronary artery disease.
Further studies are needed for wider implementation and accessibility of cardio rehabilitation in patients who have undergone coronary artery bypass surgery.
Stanislav A. Kayashkin1, Alikhan K. Dzhusipov2,
Kairat R. Karibaev3, Elena M. Ioffe4
1 Kazakhstan’s Medical University «Kazakhstan School of Public Health»,
Almaty, the Republic of Kazakhstan;
2 JSC «Central Clinical Hospital of Almaty», Almaty, the Republic of Kazakhstan;
3 Cardiological center JSC Central Clinical Hospital of Almaty, Almaty, the Republic of Kazakhstan;
4 Military Clinical Hospital of the Ministry of Defense, Almaty, the Republic of Kazakhstan.
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Kayashkin S.A., Dzhusipov A.K., Karibaev K.R., Ioffe E.M. Оptimization of follow-up of elderly patients with coronary heart disease who received a comprehensive cardio rehabilitation program after performing coronary artery bypass surgery // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 6, pp. 152-160. doi 10.34689/SH.2022.24.6.020Related publications:
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