Surgical myocardial revascularization: to the issue of predictors of long-term prognosis (literature review)

Abstract

Despite the active development of measures for the prevention and treatment of cardiovascular diseases (CVD), today the mortality rate remains high. In this regard, in recent decades, there has been a pronounced progress in the field of methods of treating patients with coronary heart disease (CHD). Undoubtedly, an important role is assigned to the improvement of methods of surgical myocardial revascularization. To reduce mortality rates it is necessary to work in various directions, including the improvement of surgical techniques, active work on the early detection of CVD. It is worth to aim at delivery a system of information support for the population on the issues of maintaining and promoting health, a healthy lifestyle, and effective drug treatment for CVD. It is actual to study factors that can influence on the course of the disease after surgery. The search for materials was carried out by analyzing open sources of English and Russian reports in the electronic databases PubMed, MEDLINE, Scopus, eLibrary, CyberLeninka, Web of Science, RSCI. A review of the literature on works aimed at identifying the most significant predictors of poor long-term prognosis after coronary artery bypass grafting (CABG) is presented. The main predictors of an unfavourable long-term prognosis after surgical myocardial revascularization include age at the time of surgery over 60–65 years, diabetes mellitus (DM), chronic kidney disease (CKD), multivessel coronary atherosclerosis, multifocal atherosclerosis (MFA), reduced fraction ejection (EF) of the left ventricle (LV) (< 50%), index coronary bypass surgery for acute coronary syndrome (ACS), a history of acute cerebrovascular accident (ACV), and myocardial infarction (MI), LV plasty.