Clinical and Instrumental Assessment of the Effectiveness of Myocardial Revascularization in Patients with Ischemic Heart Disease

Abstrak

Research objective. Conduct a comprehensive assessment of clinical, functional, biochemical, and instrumental indicators in patients with coronary heart disease (CHD) after various types of myocardial revascularization and identify risk factors for the development of cardiovascular complications.
Materials and methods. 96 patients with coronary heart disease were examined, who underwent planned myocardial revascularization. Depending on the method of intervention, patients are divided into two groups:
-I group (n = 52) - patients after percutaneous coronary intervention (PCI);
- Group II (n = 44) - patients after coronary artery bypass grafting (CAG).
The dynamics of electrocardiographic (ECG) and echocardiographic (EchoCG) indicators, troponin I levels, KFC-MV, lipid spectrum parameters, frequency of complications, and quality of life were assessed using SF-36 and KCCQ scales. Statistical analysis was performed using the SPSS 26.0 package, Student's t-test and χ2 criterion were used; differences were considered significant at p < 0.05.
Results.
Six months after the intervention, the left ventricular ejection fraction (LVEF) increased by an average of 12%, the frequency of ST segment depression and T wave inversion decreased by more than 3 times. Complete revascularization was achieved in 83% of patients after PCV and in 89% after CSH. The frequency of complications was 32.7% and 50.0%, respectively. The main predictors of complications were: LVEF < 45%, troponin level I > 0.5 ng/ml, the presence of type 2 diabetes mellitus, and NYHA functional class III-IV chronic heart failure (CHF). The SF-36 average total score increased from 48.5 to 74.5, the KCCQ scale from 49.3 to 77.9 (p < 0.001).
Conclusion.
Myocardial revascularization leads to a significant improvement in the contractile function of the myocardium and the quality of life of patients with coronary heart disease. Endovascular methods ensure faster restoration of the functional state, while surgical revascularization is characterized by a more stable hemodynamic effect in the long term. The developed risk stratification algorithm allows reducing the frequency of complications by approximately 30-35% and improving quality of life indicators by 22-28 points.

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