CORONARY ARTERY STENOSIS: IS REVASCULARIZATION ALWAYS REASONABLE?
https://doi.org/10.17802/2306-1278-2019-8-1-42-51
Abstract
Aim. To determine factors associated with percutaneous coronary intervention (PCI) and/ or coronary artery bypass grafting (CABG) in patients with stable coronary artery disease (CAD), who have no indications for myocardial revascularization.
Methods. The data were collected using the Federal CAD Registry. Medical data of 1522 patients with CAD were reviewed. Of them, 326 patients (median age – 54.7±8.7 years; 73.0% – males) who had no indications for PCI and CABG according to 2013 ESC guidelines on stable CAD (ESC 2014) were analyzed.
Results. 216 patients out of 326 (66%) patients received medical treatment. The rest 110 patients (34%) without any recommended indications underwent myocardial revascularization. Discriminate analysis determined coronary artery stenosis of >70% was the only factor reliably associated with the decision to perform myocardial revascularization in the absence of any indications (р<0.001). Almost 93% of the interventions were performed in asymptomatic patients or patients with mild angina.
Conclusion. Patients with stable CAD without any objective indications for coronary intervention may be unreasonably referred to myocardial revascularization (commonly PCI) due to coronary artery stenosis >70% regardless of whether they have or do not have angina symptoms.
About the Authors
A. S. Korotin
Regional Clinical Hospital
Russian Federation
Russian Federation
MD, cardiologist at the Cardiology Department №2,
1 Smirnovskoye Uschelie, Saratov, 410053
O. M. Posnenkova
Saratov State Medical University named after V. I. Razumovsky
Russian Federation
Russian Federation
PhD, senior researcher at the Department of Innovative Cardiological Information Technology, Cardiology Research Institute,
112 Bolshaya Kazachia St., Saratov, 410012
A. R. Kiselev
Saratov State Medical University named after V. I. Razumovsky
Russian Federation
Russian Federation
PhD, leading researcher at the Department of Innovative Cardiological Information Technology, Cardiology Research Institute,
112 Bolshaya Kazachia St., Saratov, 410012
Yu. V. Popova
Saratov State Medical University named after V. I. Razumovsky
Russian Federation
Russian Federation
PhD, researcher at the Department of Innovative Cardiological Information Technology, Cardiology Research Institute,
112 Bolshaya Kazachia St., Saratov, 410012
V. I. Gridnev
Saratov State Medical University named after V. I. Razumovsky
Russian Federation
Russian Federation
PhD, Director of the Cardiology Research Institute,
112 Bolshaya Kazachia St., Saratov, 410012
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Review
For citations:
Korotin A.S., Posnenkova O.M., Kiselev A.R., Popova Yu.V., Gridnev V.I. CORONARY ARTERY STENOSIS: IS REVASCULARIZATION ALWAYS REASONABLE? Complex Issues of Cardiovascular Diseases. 2019;8(1):42-51. (In Russ.) https://doi.org/10.17802/2306-1278-2019-8-1-42-51
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