Factor Analysis of Predicting Cardiovascular Death in the Remote Period after Myocardial Revascularization

ORIGINAL ARTICLE
Ekaterina S. Levitskaya¹*, PhD; Mikhail M. Batiushin¹, PhD, ScD; Elena O. Golovinova¹; Valentina V. Gul'chenko¹; Vladimir A. Chistjakov¹, ²; Dmitriy G. Pasechnik¹

¹Rostov State Medical University, ²Southern Federal University; Rostov-on-Don, Russia

*Corresponding author: Ekaterina S. Levitskaya, PhD. Rostov State Medical University, Rostov-on-Don, Russia.  E-mail: es.med@mail.ru

Published: September 12, 2015. DOI: 10.21103/Article5(3)_OA1

Abstract: 

The aim of the present study was to analyze the impact of traditional and renal risk factors (RFs) on the probability of cardiovascular death in CHD patients in the remote period after myocardial revascularization (MR).

Materials and Methods: The present study included 90 CHD patients (80 men and 10 women; mean age 56.1±0.9 years) with indications for MR. The prevalence of major cardiovascular RFs (old age, gender, duration of CHD, arterial hypertension, diabetes mellitus, another localization of atherosclerotic lesions, and the presence and duration of smoking) and the main echocardiographic parameters and the parameters of renal function  (MAU and GFR) were assessed. Fatal cardiovascular outcomes were the only endpoint of the study.

 Results: Cardiovascular death (CVD) occurred in 10/12.3% patients. The studied RFs, such as the patient's age, duration of smoking, and presence of angina with low tolerance to physical stress, had a significant impact on the probability of death in CHD patients. Risk of CVD (rCVD) over a long-term period increases by 18.1% in patients with elevated levels of total cholesterol, by 16.2% in patients with stable angina pectoris class III, by 50.5% in patients with atherosclerotic lesions of lower limb and cerebral arteries, and by 69.3% in patients suffering from overweight. Left atrial size, LVPWT, and LVMI were also significant predictors of adverse cardiovascular prognosis. The increase in the number of coronary arteries with clinically significant stenosis, including subtotal narrowing of the vessel lumen, increases rCVD in the long-term period. The important role of a highly reliable level of glucose in the urine for the risk score was found. The presence of CKD stage 3 and the impaired GFR also significantly increased rCVD.

Conclusion: Our data demonstrate a high medical and social importance of a comprehensive and integrated analysis not only of traditional RFs, but also of markers of renal dysfunction in risk stratification of cardiovascular prognosis in CHD patients.

Keywords: 
coronary heart disease; myocardial revascularization; risk factors; prognosis.
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Int  J Biomed. 2015; 5(3):117-122. © 2015 International Medical Research and Development Corporation. All rights reserved.