Results of coronary artery bypass grafting in patients of different age groups

Tarasov R.S.¹, Kazantsev A.N.², Glebov K.K.¹, Lider R.Yu.³, Burkov N.N.^1,2

1) Scientific Research Institute for Complex Problems of Cardiovascular Diseases,
2) Kemerovo Regional Clinical Cardiological Dispensary named after Academician L.S. Barbarash,
3) Kemerovo State Medical University of the RF Ministry of Public Health, Kemerovo

Background. Myocardial revascularization involves a wide range of invasive strategies aimed at treating ischaemic heart disease in patients of different age groups.

Objective. The purpose of the present study was to analyze the outcomes of coronary artery bypass grafting in patients depending on age.

Patients and methods. A total of 905 patients enrolled in our study were subdivided into groups based on age-related characteristics (young age, middle age, old age, senile age). The endpoints of follow up were as follows: myocardial infarction, acute impairment of cerebral circulation, death and haemorrhagic complications.

Results. It should be mentioned that the groups were comparable by the majority of the parameters studied. No statistically significant differences in the frequency of the development of complications in the postoperative period were observed. However, amongst patients over 75 years old, revision of the mediastinum for haemorrhage was performed more often.

Discussion. Patients of different age groups undergoing coronary artery bypass grafting are extremely heterogeneous by the clinical, anamnestic, instrumental and intraoperative characteristics. A high frequency of haemorrhagic complications amongst patients over 75 years old may be explained by a more aggressive approach to the regimens of anticoagulant/antiaggregant therapy resulting form the presence of atrial fibrillation. In its turn, this fact determines the probability of a high frequency of the development of adverse cardiovascular events. An individual approach to the choice and scope of the strategy of revascularization in patients of different age groups is the fundamental principle for an optimal outcome of coronary surgery.

Conclusion. The obtained findings and analysis of the statistical data are indicative of the necessity of personified selection of the technique of a surgical intervention for each particular patient, which will make it possible to decrease the rate of adverse cardiovascular events in the postoperative period.

KEY WORDS: coronary artery bypass grafting, multifocal atherosclerosis, myocardial revascularization, in-hospital results, age-related peculiarities.

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