kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”kpccz-1522Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Сердечно-сосудистая хирургияREVIEWS. Cardiovascular surgeryСРАВНЕНИЕ ЭФФЕКТИВНОСТИ АОРТОКОРОНАРНОГО ШУНТИРОВАНИЯ И ЧРЕСКОЖНОГО КОРОНАРНОГО ВМЕШАТЕЛЬСТВА В РАЗЛИЧНЫХ КЛИНИЧЕСКИХ СИТУАЦИЯХCOMPARISON OF THE EFFECTIVENESS OF CORONARY ARTERY BYPASS GRAFTING AND PERCUTANEOUS CORONARY INTERVENTION IN VARIOUS CLINICAL SITUATIONShttps://orcid.org/0000-0001-6407-3880ТрусовЮрий АлександровичTrusovYuri A.

врач-кардиолог, ассистент федерального государственного бюджетного образовательного учреждения высшего образования «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Самара, Российская Федерация

cardiologist, assistant, Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Health of the Russian Federation, Samara, Russian Federation

doctr@autorambler.ruhttps://orcid.org/0009-0002-9090-0688РашидоваСеда СулеймановнаRashidovaSeda S.

врач-кардиолог государственного бюджетного учреждения Республики Дагестан «Перинатальный центр г. Хасавюрта», Хасавюрт, Российская Федерация

cardiologist, State Budgetary Institution of the Republic of Dagestan “Perinatal CenterKhasavyurt”, Khasavyurt, Russian Federation

https://orcid.org/0009-0003-9690-7220АмирхановаАлсу АйбулатовнаAmirkhanovaAlsu A.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Уфа, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University”, Ministries Health Care of the Russian Federation, Ufa, Russian Federation

https://orcid.org/0009-0007-0269-2628ВиноградоваЕкатерина ЮрьевнаVinogradovaEkaterina Yu.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Кировский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Киров, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Kirov State Medical University” of the Ministry of Health of the Russian Federation, Kirov, Russian Federation

https://orcid.org/0009-0000-5960-6507ЧонкаевБекир ДжелиловичChonkaevBekir D.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Воронежский государственный медицинский университет имени Н.Н. Бурденко» Министерства здравоохранения Российской Федерации, Воронеж, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Voronezh State Medical University named after N.N. Burdenko” of the Ministry of Health of the Russian Federation, Voronezh, Russian Federation

https://orcid.org/0009-0001-7259-0973БелозерцевВладислав ЛьвовичBelozertsevVladislav L.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Уфа, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University”, Ministries Health Care of the Russian Federation, Ufa, Russian Federation

https://orcid.org/0009-0003-4837-4327БархамАдхам Б.Ф.BarhamAdham B.F.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Марийский государственный университет», Йошкар-Ола, Российская Федерация

student,  Federal State Budgetary Educational Institution of Higher Education “Mari State University”, Yoshkar-Ola, Russian Federation

https://orcid.org/0009-0007-1987-7813ПодъячеваЕкатерина НиколаевнаPodyachevaEkaterina N.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Мордовский государственный университет им. Н.П. Огарева», Саранск, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “N.P. Ogarev Mordovian State University”, Saransk, Russian Federation

https://orcid.org/0000-0002-5737-0761МельниченкоОльга ГеннадьевнаMelnichenkoOlga G.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Оренбургский государственный медицинский университет» Министерства здравоохранения Российской Федерации Оренбург, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Orenburg State Medical University” of the Ministry of Health of the Russian Federation, Russian Federation

https://orcid.org/0009-0001-9686-4000ДмитриеваАлина ВитальевнаDmitrievaAlina V.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Уфа, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University”, Ministries Health Care of the Russian Federation, Ufa, Russian Federation

https://orcid.org/0009-0001-6044-2826ЯкуповаЭлина ИльдаровнаYakupovaElina I.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Уфа, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University”, Ministries Health Care of the Russian Federation, Ufa, Russian Federation

https://orcid.org/0009-0004-5905-8044ЗайнидиноваШукрона УлугбековнаZainidinovaShukrona U.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Уфа, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University”, Ministries Health Care of the Russian Federation, Ufa, Russian Federation

Федеральное государственное бюджетное образовательное учреждение высшего образования «Самарский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Health of the Russian FederationRussian FederationГосударственное бюджетное учреждение Республики Дагестан «Перинатальный центр г. Хасавюрта»РоссияState Budgetary Institution of the Republic of Dagestan “Perinatal CenterKhasavyurt”Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Bashkir State Medical University” Ministry of Healthcare of the Russian FederationRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Кировский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Kirov State Medical University” of the Ministry of Health of the Russian FederationRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Воронежский государственный медицинский университет имени Н.Н. Бурденко» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Voronezh State Medical University named after N.N. Burdenko” of the Ministry of Health of the Russian FederationRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Марийский государственный университет»РоссияFederal State Budgetary Educational Institution of Higher Education “Mari State University”Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Мордовский государственный университет им. Н.П. Огарева»РоссияFederal State Budgetary Educational Institution of Higher Education “N.P. Ogarev Mordovian State University”Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Оренбургский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Orenburg State Medical University” of the Ministry of Health of the Russian FederationRussian Federation202502122024141103121Copyright © Трусов Ю.А., Рашидова С.С., Амирханова А.А., Виноградова Е.Ю., Чонкаев Б.Д., Белозерцев В.Л., Бархам А.Б., Подъячева Е.Н., Мельниченко О.Г., Дмитриева А.В., Якупова Э.И., Зайнидинова Ш.У., 20252025Трусов Ю.А., Рашидова С.С., Амирханова А.А., Виноградова Е.Ю., Чонкаев Б.Д., Белозерцев В.Л., Бархам А.Б., Подъячева Е.Н., Мельниченко О.Г., Дмитриева А.В., Якупова Э.И., Зайнидинова Ш.У.Trusov Y.A., Rashidova S.S., Amirkhanova A.A., Vinogradova E.Y., Chonkaev B.D., Belozertsev V.L., Barham A.B., Podyacheva E.N., Melnichenko O.G., Dmitrieva A.V., Yakupova E.I., Zainidinova S.U.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1522Основные положения

Основные положения

Уникальный клинический профиль каждого пациента и анатомия коронарных артерий должны учитываться в процессе принятия решения при выборе между чрескожным коронарным вмешательством (ЧКВ) или аортокоронарным шунтированием (АКШ). Шкала SYNTAX может помочь в принятии решений, прогнозируя риск нежелательных явлений и определяя выбор между ЧКВ и АКШ, но существует потенциальная польза от оценки по шкале SYNTAX II, которая позволяет лучше стратифицировать пациентов.

 

 

Аннотация

Аннотация

В Российской Федерации 46% всех смертей от сердечно-сосудистых заболеваний приходится на хроническую ИБС. По данным регистров, даже в условиях применения современных эффективных лекарственных средств 5‑летняя смертность пациентов с хронической ИБС остается высокой и составляет около 20%. Оптимальный подход к лечению пациентов с ИБС зависит от различных факторов, таких как степень распространенности и сложность патологического процесса, характеристики пациента и индивидуальные предпочтения. Шкала SYNTAX может помочь в принятии решений, прогнозируя риск нежелательных явлений и определяя выбор между ЧКВ и АКШ, но существует потенциальная польза от оценки по шкале SYNTAX II, которая позволяет лучше стратифицировать пациентов. Дискуссия о выборе между АКШ и ЧКВ в различных клинических ситуациях будет продолжать развиваться по мере совершенствования инструментов стратификации рисков, технологий и процедурных приемов как для АКШ, так и для ЧКВ. В связи с постоянным прогрессом в ближайшие годы изменятся рекомендации по реваскуляризации для конкретных групп пациентов. Настоящий обзор литературы имеет ряд отличий от ранее опубликованных, включая широкий охват исследований, разнообразие клинических ситуаций, оценка долгосрочных результатов, широкий анализ подгрупп пациентов, а также оценку ограничений существующих исследований.

HighlightsThe unique clinical profile of each patient and the anatomy of the coronary arteries should be taken into account in the decision-making process when choosing between percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The SYNTAX scale can help in decision-making by predicting the risk of adverse events and determining the choice between PCI and CABG, but there is a potential benefit from the assessment on the SYNTAX II scale, which allows for better stratification of patients.Annotation

In the Russian Federation, 46% of all deaths from cardiovascular diseases are due to chronic coronary heart disease. According to the registers, even under the conditions of using modern effective medicines, the 5‑year mortality rate of patients with chronic coronary heart disease remains high and is about 20%. The optimal approach to the treatment of patients with coronary heart disease depends on various factors, such as the degree of prevalence and complexity of the pathological process, patient characteristics and individual preferences. The SYNTAX scale can help in decision-making by predicting the risk of adverse events and determining the choice between PCI and CABG, but there is a potential benefit from the assessment on the SYNTAX II scale, which allows for better stratification of patients. The discussion on the choice between CABG and PCI in various clinical situations will continue to evolve as risk stratification tools, technologies and procedural techniques for both CABG and PCI are improved. Due to continuous progress, revascularization recommendations for specific patient groups will change in the coming years. This literature review has a number of differences from previously published ones, including a wide range of studies, a variety of clinical situations, an assessment of long-term results, a broad analysis of patient subgroups, as well as an assessment of the limitations of existing studies.

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