ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 10 of 39
JMBS 2021, 6(2): 71–76
Clinical Medicine

Analysis of Comorbidity in High-Risk Patients with Complicated Coronary Artery Disease before Cardiac Surgery

Gogayeva Olena

Aim: To analyze comorbidity in high-risk patients with complicated forms of coronary artery disease before cardiac surgery. Materials and methods: Retrospective analysis of 160 randomly selected high-risk patients with complicated coronary artery disease who underwent open-heart surgery and were discharged from the Institute in the period from 2009 to 2019. The average age of patients was 59.06±9.8 years. All the patients underwent routine clinical and laboratory tests, electrocardiography, echocardiography, coronary angiography and cardiac surgery. Before cardiac surgery was performed risk stratification of patients on EuroSCORE II scale, according to the calculation, the severity of patients averaged 10.08%, which indicates a high risk of surgical death. The severity on the EuroSCORE II scale for patients with postinfarction left ventricular aneurysms was in average 9.9%, in patients with ischemic mitral regurgitation - 12.4%, and among patients with a combination of coronary artery disease with aortic valve disease, the risk of surgical death was in average 9, 2%. Results: When analyzing the baseline status of 160 high-risk patients with complicated forms of coronary artery disease, it was found that the average body mass index of patients was 28.9±4.04 kg/m2 [range 20.76-40.5 kg/m2], the level of glucose on admission was in average 6.8±2.6 mmol/l [range 3.4-21.6 mmol/l], serum creatinine averaged 107.2±25.2 μmol/l [range 56-207 μmol/l], and the estimated glomerular filtration rate averaged 67.9±18.03 ml/min/1.73 m2 [range 28-120 ml/min/1.73 m2]. Thus, 68 (42.5%) patients were overweight, 60 (37.5%) had obesity I-III st., 40 (25%) - type 2 diabetes mellitus, 79 (49.3%) - impaired glucose tolerance. 57 (35.6%) patients had chronic kidney disease with glomerular filtration rate <60 ml / min / 1.73 m2. Atherosclerotic stenosis of the carotid arteries >50% was diagnosed on Doppler study of brachiocephalic arteries in 35 (21.8%) patients. Varicose veins of the lower extremities C4-C6 stages had 42 (26.2%) patients. For 124 (77.5%) patients atherosclerosis of lower extremities arteries of different stages. Chronic obstructive pulmonary disease had 130 (81.2%) patients. 122 (76,2%) patients had a bad habit in the form of smoking, among which 20 (12.5%) continued smoking during hospitalization. 10 (6.25%) patients had gouty arthritis. Despite a high predicted mortality of 10.08% on the EuroSCORE II scale, all patients were discharged after successful surgery. Conclusions: Management of cardiac surgery patients with high-risk coronary artery disease in the perioperative period has its own characteristics and requires a personalized approach, taking into account not only cardiac features, but also comorbidity that have a great prognostic value

Keywords: coronary artery disease, complicated forms, high-risk patient, comorbidity, cardiac surgery

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