Metrika

  • citati u SCIndeksu: 0
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[]
  • posete u poslednjih 30 dana:17
  • preuzimanja u poslednjih 30 dana:2

Sadržaj

članak: 3 od 705  
Back povratak na rezultate
2021, vol. 78, br. 7, str. 701-707
Da li je u redu kada kardiohirurški konzilijum promeni odluku o načinu revaskularizacije miokarda?
aUniverzitet u Beogradu, Medicinski fakultet, Institut za kardiovaskularne bolesti 'Dedinje'
bUniverzitet u Beogradu, Medicinski fakultet, Institut za kardiovaskularne bolesti 'Dedinje' + Univerzitet u Beogradu, Medicinski fakultet

e-adresapotasevic@yahoo.com
Sažetak
Uvod/Cilj. Odlučivanje od strane kardiohirurškog konzilijuma je uspostavljen način donošenja odgovarajućih odluka koje se tiču zbrinjavanja bolesnika sa oboljenjem koronarnih arterija. U kliničkoj praksi nisu retkost promene u odlukama različitih kardiohirurških konzilijuma. Međutim, kliničke implikacije u vezi sa promenama odluka kardiohirurških konzilijuma nisu jasne. Cilj rada je bio da se utvrde kliničke implikacije promene u odluci kardiohirurškog konzilijuma kod bolesnika kojima je prvo preporučena hirurška revaskularizacija miokarda, ali je TA odluka posledično promenjena u perkutanu koronarnu intervenciju (PKI). Metode. Retrospektivno su analizirani podaci za 1 501 bolesnika koji su bili primljeni u jedan centar visokog obima tercijarne nege za koronarni arterijski bajpas grafting (KABG). Kod svih bolesnika odluke su bile donete od strane kardiohirurškog konzilijuma pre prijema. Posle prijema, odluke su ponovo procenjivane od strane drugog kardiohiruškog konzilijuma. Odluka o načinu revaskularizacije promenjena je kod 73 (4,86%) bolesnika. Urađeno je usklađivanje skora podudarnja sa bolesnicima iz iste populacije koji su podvrgnuti KABG. Bolesnici u obe grupe praćeni su zbog velikih neželjenih kardiovaskularnih događaja (VNKVD) i ukupnog mortaliteta tokom 12 meseci. Rezultati. Grupe PKI i KABG bile su uravnotežene u odnosu na demografske i kliničke karakteristike. Svi bolesnici su imali dvosudovnu ili trosudovnu koronarnu bolest, sa sličnom učestalošću stenoze glavnog stabla (26% u PKI i 30,10% u KABG grupi). EuroSCORE II je bio sličan između grupa (2,48 ± 2,38 vs. 2,36 ± 2,92). Tokom perioda praćenja primećeno je ukupno 5 (6,80%) VNKVD u PKI grupi i 12 (5,80%) VNKVD u KABG grupi (log rank 0,096, p = 0,757). Ukupno 6 (8,20%) bolesnika umrlo je u grupi PKI, a 15 (7,30%) je umrlo u KABG grupi (log rank 0,067, p = 0,796). Zaključak. Naši podaci ukazuju na to da bolesnici kojima je prvi put savetovan KABG, ali je odluka posledično promenjena na PKI imaju sličnu prognozu kao i bolesnici sa KABG, 12 meseci nakon indeksne procedure.
Reference
Novododat članak: provera, normiranje i linkovanje referenci u toku.
Piccolo R, Windecker S, Kolh P. Myocardial revascularization in patients with left main or multivessel coronary artery disease at high surgical risk: conventional wisdom versus risk prediction model. Eur J Cardiothorac Surg 2017; 51(5): 949-51
Neuman FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization The Task Force on myocardial revascularization of the European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2019; 40(2): 87-165
Chang K, Koh YS, Jeong SH, Lee JM, Her SH, Park HJ, et al. Long-term outcomes of percutaneous coronary intervention versus coronary artery bypass grafting for unprotected left main coronary bifurcation disease in the drug-eluting stent era. Heart 2012; 98(10): 799-805
Spadaccio C, Benedetto U. Coronary artery bypass grafting (CABG) vs. percutaneous coronary intervention (PCI) in the treatment of multivessel coronary disease: quo vadis? -a review of the evidences on coronary artery disease. Ann Cardiothorac Surg 2018; 7(4): 506-15
Babapulle MN, Joseph L, Bélisle P, Brophy JM, Eisenberg MJ. A hierarchical Bayesian meta-analysis of randomised clinical trials of drug-eluting stents. Lancet 2004; 364(9434): 583-91
Bavry AA, Kumbhani DJ, Helton TJ, Borek PP, Mood GR, Bhatt DL. Late thrombosis of drug-eluting stents: A meta-analysis of randomized clinical trials. Am J Med 2006; 119(12): 1056-61
Chang M, Lee CW, Ahn JM, Cavalcante R, Sotomi Y, Onuma Y. Coronary artery bypass graft surgery versus drug-eluting stent implantation for high-surgical-risk patients with left main or multivessel coronary artery disease. Eur J Cardiothorac Surg 2017; 51(5): 943-9
Morice MC, Serruys PW, Kappetein AP, Feldman TE, Stahle E, Colombo A, et al. Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the synergy between percutaneous coronary intervention with TAXUS and cardiac surgery (SYNTAX) trial. Circulation 2010; 121(24): 2645-53
Head SJ, Kaul S, Mack MJ, Serruys PW, Taggart DP, Holmes DR Jr, et al. The rationale for Heart Team decision-making for patients with stable, complex coronary artery disease. Eur Heart J 2013; 34(32): 2510-8
Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease. N Engl J Med 2009; 360(10): 961-72
Farooq V, van Klaveren D, Steyerberg EW, Meliga E, Vergouwe Y, Chieffo A, et al. Anatomical and clinical characteristics to guide decision making between coronary artery bypass surgery and percutaneous coronary intervention for individual patients: development and validation of SYNTAX score II. Lancet 2013; 381(9867): 639-50
Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Surg 2012
Kukreja N, Serruys PW, De Bruyne B, Colombo A, Macaya C, Richardt G, et al. Sirolimus-eluting stents, bare metal stents or coronary artery bypass grafting for patients with multivessel disease including involvement of the proximal left anterior descending artery: analysis of the Arterial Revascularization Therapies study part 2 (ARTS-II). Heart 2009; 95(13): 1061-6
Mohr FW, Morice MC, Kappetein AP, Feldman TE, Stahle E, Colombo A, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet 2013; 381(9867): 629-38
Kappetein AP, Feldman TE, Mack MJ, Morice MC, Holmes DR, Stahle E, et al. Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial. Eur Heart J 2011; 32(17): 2125-34
Bansilal S, Farkouh ME, Hueb W, Ogdie M, Dangas G, Lansky AJ, et al. The Future Revascularization Evaluation in patients with Diabetes mellitus: optimal management of Multivessel disease (FREEDOM) trial: clinical and angiographic profile at study entry. Am Heart J 2012; 164(4): 591-9
Morrison DA, Sethi G, Sacks J, Henderson W, Grover F, Sedlis S, et al. Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass: a multicenter, randomized trial. Investigators of the Department of Veterans Affairs Cooperative Study #385, the Angina With Extremely Serious Operative Mortality Evaluation (AWESOME). J Am Coll Cardiol 2001; 38(1): 143-9
 

O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.2298/VSP190704120V
primljen: 04.07.2019.
revidiran: 28.08.2019.
prihvaćen: 01.10.2019.
objavljen onlajn: 16.10.2019.
objavljen u SCIndeksu: 07.08.2021.
metod recenzije: dvostruko anoniman
Creative Commons License 4.0

Povezani članci

Nema povezanih članaka