cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2022.3.n1948cardio-1948Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESФакторы, связанные со смертностью от всех причин у пациентов с хронической тотальной окклюзией коронарных артерий, подвергающихся реваскуляризации (чрескожное вмешательство или коронарное шунтирование) или медикаментозному лечениюFactors associated with all-cause mortality in patients with coronary artery chronic total occlusions undergoing revascularization (percutaneous coronary intervention or surgery) or medical treatmentАсланБ.AslanB.

MD

Диярбакыр

Burhan Aslan, MD

Diyarbakır

burhanaslndr@gmail.comОзбекМ.ÖzbekM.

MD

Диярбакыр

Mehmet Özbek, MD

Diyarbakır

dr.mehmetozbek@hotmail.comАктанА.AktanA.

 MD

Мардин

Adem Aktan, MD

Mardin

dradem21@gmail.comБойразБ.BoyrazB.

MD

Битлис

Bedrettin Boyraz, MD

Bitlis

bedrettinboyraz@yahoo.comТенекечиоглуЭ.TenekecioğluE.

MD

Бурса

Erhan Tenekecioğlu, MD

Bursa

drercardio2@gmail.comУниверситет медицинских наук, Учебно-исследовательский госпиталь Гази ЯшаргилТурцияHealth Science University, Gazi Yaşargil Training and Research HospitalTurkeyУниверситет ДиклеТурцияDicle UniversityTurkeyГосударственная больница МардинаТурцияMardin State HospitalTurkeyТатванская государственная больницаTurkeyTatvan State HospitalTurkeyУчебно-исследовательский госпиталь БурсыТурцияBursa Training and research HospitalTurkey2022310320226234955Copyright © Kardiomag, 20222022KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1948

Цель    Хроническая тотальная окклюзия коронарной артерии является предиктором ранней и поздней сердечно-сосудистой смертности и неблагоприятных сердечно-сосудистых событий у пациентов с ишемической болезнью сердца. Целью настоящего исследования было выявление предикторов смертности от всех причин у больных с хронической тотальной окклюзией коронарной артерии, перенесших инвазивное лечение.Материал и методы    В исследование ретроспективно были включены пациенты в период с 2012 по 2018 г. с хронической тотальной окклюзией коронарной артерии как минимум одного сосуда, подтвержденной коронарографией. Пациенты были разделены на две группы: группу интервенционного лечения (чрескожные или хирургические вмешательства) и группу медикаментозной терапии.Результаты    Было обследовано 543 пациента: 152 женщины (28%) и 391 мужчина (72%). Медиана периода наблюдения составила 49 (26–72) мес. Проспективное наблюдение осуществлено в отношении 186 (34,2%) пациентов, получающих только медикаментозню терапию, и 357 (65,8%) пациентов группы инвазивной терапии. Развитие летального исхода в течение 5 лет наблюдения регистрировалось у 50 (26,9%) пациентов в терапевтической группе и у 53 (14,8%) пациентов в группе интервенционных вмешательства (p = 0,001). По результатам многофакторного анализа сердечная недостаточность (отношение шансов (ОШ): 1,92, 95% ДИ: 1,18–3,14; р = 0,009), высокий уровень глюкозы (ОШ: 1.05, 95% ДИ: 1,02-1.08; p = 0.041), низкий уровень альбумина (ОШ: 0,49, 95% ДИ: 0,32–0,72; р = 0,001), выраженность коронарного атеросклероза по SYNTAX (ОШ: 1,03, 95% ДИ: 1,01–1,05; р = 0,001) и наличие хронической тотальной окклюзии ≥2 артерий (ОШ: 0,42 , 95% ДИ: 0,22-0,72; p = 0,01) явились независимыми факторами смертности от всех причин.Заключение    По сравнению с группой больных, перенесших реваскуляризацию, среди пациентов с хронической тотальной окклюзией коронарной артерии, получавших только медикаментозное лечение, наблюдалось увеличение смертности. Сердечная недостаточность, балл SYNTAX, альбумин, глюкоза и наличие хронической тотальной окклюзии ≥2 артерий были независимыми факторами риска смертности от всех причин.

Aim    Chronic total occlusion of a coronary artery (CTO) is a predictor of early and late cardiovascular mortality and poor cardiovascular outcomes in patients with coronary artery disease. The purpose of this study was to identify predictors of all-cause mortality in CTO patients that underwent invasive treatment.Material and methods    Patients between 2012 and 2018 with CTO in at least one vessel, as demonstrated by coronary angiography, were included retrospectively in the study. The patients were divided into two groups, an intervention group (percutaneous and surgical revascularization) and a medical group.Results    A total of 543 patients were studied, 152 females (28%) and 391 males (72%). The median follow-up period was 49 (26–72) mos. A total of 186 (34.2%) patients in the medical group and 357 (65.8%) patients in the invasive therapy group were followed. The 5-yr death rate was observed in 50 (26.9%) patients in the medical group and 53 (14.8%) patients in the intervention group, and it was found to be statistically higher in the medical group (p=0.001). In multivariable analysis, heart failure (odds ratio (OR): 1.92, 95% CI: 1.18-3.14; p=0.01), higher glucose levels (OR: 1.05, 95% CI: 1,02-1.08; p=0.04), lower albumin levels (OR: 0.49, 95% Cl: 0.32-0.72; p=0.001), SYNTAX score (OR: 1.03, 95% CI: 1.01-1.05; p=0.001), and CTO (≥2 occluded artery) (OR: 0.42, 95% CI: 0.22-0.72; p=0.01) were independent factors for all-cause mortality.Conclusion    In comparison to the revascularized group, there was an increase in mortality among CTO patients treated medically. Heart failure, SYNTAX score, albumin, glucose, and CTO (≥2 occluded arteries) were independent risk factors for all-cause mortality.

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The authors declare that there are no conflicts of interest present.