Кардиоваскулярная терапия и профилактика (Apr 2016)

Prevalence of comorbidities and their influence on complications and outcomes of coronary bypass surgery for coronary heart disease in gender perspective

  • E. B. Klester,
  • O. A. Ivanov,
  • D. S. Budnev,
  • V. A. Elykomov

DOI
https://doi.org/10.15829/1728-8800-2016-2-32-37
Journal volume & issue
Vol. 15, no. 2
pp. 32 – 37

Abstract

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Aim. To study prevalence of cardiovascular, respiratory, urinary tract and gastrointestinal comorbidity for the improvement of prediction of complications and adverse outcomes in coronary bypass surgery in patients with coronary heart disease, incl. gender differences.Material and methods. We observed 127 patients (73,2% — males, 26,8% — females), operated for ischemic heart disease in Altai regional clinical hospital. Mean age at the moment of surgery was 58,9±6,3 y.o. Bypass operation was done as indicated, under on-pump conditions with pharmaco-cold cardioplegy.Results. Comorbidity index by Charlson (CIС) was 4,7 [4,1-5,3] points; in men — 3,6 [3,2-4,1], in women — 5,2 [4,7-5,6] (p5) у for women — 58,8% vs 36,6% (р=0,04). CIC correlated with the following operation complications: heart failure required inotropes for >5 days (r=0,73); perioperation myocardial infarction (r=0,71); acute disorder of brain circulation confirmed by computed tomography (r=0,56); heart rhythm disorders: atrial fibrillation, paroxysmal ventricular tachycardia (r=0,52); respiratory failure led to prolonged artificial ventilatory support >5 days. (r=0,48).Conclusion. CIC shows gender differences and is characterized by higher risk of adverse outcomes in women: survival 70 y.o., heart failure, diabetes, chronic kidney disease (≥III stage) and duration of on-pump period.

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