A.V. Rudenko, O.I. Mitchenko, Yu.V. Panichkin, V.Yu. Romanov, M.M. Gelmedova, V.V. Gutovskyi.Follow-up of patients with multiple coronary atherosclerosis after coronary artery bypass grafting.

The aim of the study was to assess the changes of risk factors and angiography data in patients with multiple coronary atherosclerosis one year after coronary artery bypass grafting (CABG). We included 102 patients with multiple coronary atherosclerosis verified by angiography. All patients were examined before surgical treatment according to the protocol. They received advice on lifestyle modifications and individual therapy according to the current national and international guidelines. Repeated extended investigation was conducted in 73 patients, among them angiography was performed in 62 patients. According the results of repeated examinations three groups for analysis based on adherence to treatment were formed: group 1 (n=22) – high compliance, group 2 (n=36) – intermediate compliance, group 3 (n=15) – patients who discontinued treatment on their own. In general, the examined patients had low adherence to treatment, only 1/3 patients fulfilled all medical advices. This had direct impact upon state of the coronary vessels one year after CABG. In group 1 all parameters improved or did not deteriorated, which was combined with the lowest degree of progression of coronary atherosclerosis. In group 2 the changes were minor with tendency to deterioration, progression of atherosclerosis was moderate. In group 3 the most negative changes in the qualitative assessment of progression occurred in 100 % of cases, quantitative changes were the most among all groups. Progression of coronary atherosclerosis in groups 2 and 3 might be due to the low adherence to treatment. Progression of coronary atherosclerosis in group 1, despite high adherence to treatment, may also be associated with abdominal obesity and diabetes mellitus.

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