Российский кардиологический журнал (Feb 2016)

LONG TERM RESULTS OF PERCUTANEOUS CORONARY INTERVENTIONS COMPARING WITH CONSERVATIVE MANAGEMENT IN TREATMENT OF STABLE ISCHEMIC HEART DISEASE PATIENTS UNDER REAL CIRCUMSTANCES

  • V. A. Kuznetsov,
  • E. P. Samoylova,
  • I. S. Bessonov,
  • E. P. Gultyaeva,
  • I. P. Zyryanov,
  • S. G. Berdinskikh,
  • E. A. Gorbatenko,
  • G. V. Kolunin

DOI
https://doi.org/10.15829/1560-4071-2016-2-7-11
Journal volume & issue
Vol. 0, no. 2
pp. 7 – 11

Abstract

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Aim. To evaluate long term results of percutaneous coronary interventions (PCI) in stable ischemic heart disease patients (IHD) under real clinical circumstances.Material and methods. The PCI group consisted of 150 patients with stable IHD after PCI, randomly selected from the Registry of Coronary Angiography. Comparison group consisted of randomly selected from the Registry 150 patients with stable IHD receiving only drug therapy (DT).Results. In long term perion it was found that total mortality (4,0% vs. 11,3%, p=0,017) and cardiovascular mortality (3,3% vs. 10,7%, p=0,013) were lower in PCI group. After PCI there was rarer coronary bypass operation need (2,0% vs. 10,0%, p=0,004). By the prevalence of myocardial infarction in compared groups there were no statistically significant differences (6,7% vs. 5,3%, p=0,627). Kaplan-Meier curve analysis showed that positive effect of PCI was fulfilled in 15 months and progressively increased until the end of follow-up. In stepped regression of Cox proportional risks it was revealed that in long term period PCI performing associated with the increase of survival rate 2,8 times (RR=2,81, 95% CI 1,03-7,69, p=0,044). Long term survival showed independent relation with the grade of coronary lesion. In PCI group, as in DT group, there were no positive dynamics of angina functional classes. In MT group during the follow-up functional class of heart failure became harder than in PCI group, and in PCI groupthere were no significant dynamics of heart failure functional class.Conclusion. Real clinical practice proved the effectiveness of PCI with DT in treatment of stable IHD. In long term results evaluation, PCI for stable IHD associated with the increase of survival 2,8 times comparing with the group with only DT. Positive PCI effect realized after 15 months and progressively increased to the end of follow-up.

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