COMORBIDITIES IN PATIENTS WITH CORONARY ARTERY DISEASE ADMITTED TO CARDIAC SURGERY CENTERS IN CHELYABINSK AND KEMEROVO

Aims. To estimate the detection rate of comorbidities in patients admitted for surgical treatment of coronary artery disease (CAD) and to compare surgical treatment options in two cardiac surgery centers.

Methods. All the patients older 18 years who underwent coronary artery bypass grafting in 2014 (isolated or combined coronary artery bypass grafting and heart valve repair or replacement and/or aneurysmectomy) admitted to the Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo (Kemerovo group; n =1166) and in the Federal Center for Cardiovascular Surgery, Chelyabinsk (Chelyabinsk group; n = 1293) were included in the study.

Results. The mean age of patients in the Kemerovo group was 62.5±7.8 years, and in the Chelyabinsk group 61.3±7.8 years (p <0.0001). There were significant differences in the incidence rate of postinfarction cardiosclerosis between Kemerovo and Chelyabinsk (66.7% vs. 85.6%, p<0.0001). Patients in the Kemerovo group commonly had obstructive pulmonary disease (13.9 vs 6.2%, p<0.0001), previous acute cerebrovascular accident (7.1 vs 4.6%, p<0.007), atherosclerosis oflower extremity arteries (10.7 vs 3.2%, p<0.0001), gastroduodenal ulcer (15.3 vs 11.0%, p<0.002) compared to patients in the Chelyabinsk group. On average, there are 0.6±0.02 of the above mentioned dis eases per one patient in Kemerovo and0.4±0.01 in Chelyabinsk (p<0.0001). Patients in the Kemerovo group commonly underwent stenting of coronary arteries (13.0 vs 9.9%, p<0.014) compared to patients in the Chelyabinsk group.

Each fourth patient underwent combined CABG and the other surgeries in Chelyabinsk, whereas in Kemerovo each sixth patient receivedcombined surgical treatment(p<0.0001). The number of combined CABG and left ventricular reconstruction was comparable in both centers.

The linear regression analysis reported that the du-ration of surgery and cardiopulmonary bypass time are statistically significantly associated with the performance of combined surgeries (p<0.0001), the presence of comorbidities (p<0.0001) and patient age (p<0.05).

Conclusion. Patients in the Kemerovo group commonly suffered from concomitant coronary artery disease, whereas patients in theChelyabinsk group were present with postinfarction cardiosclerosis. Each fourth patient underwent combined surgery in Chelyabinsk, whereas in Kemerovo each sixth patient received combined surgical treatment. The number of combined CABG and left ventricular reconstruction was comparable in both centers.

comorbidity, cardiac surgery center, coronary artery bypass grafting, combined surgery

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