G.V. Knyshov, O.V. Levchyshyna Study of possible coronary atherosclerosis progress as a result of outside influences: coronary artery bypass grafting and stenting

The chronic coronary artery disease takes a leading place in the structure of general morbidity and mortality of world population, including Ukraine. Apart from medical therapy, coronary artery bypass grafting and stenting are used for the treatment of this pathology. All these direct methods of myocardial revascularization can’t influence the cause of atherosclerosis and don’t stop its pathogenesis. The aim of our research was study the influence of surgical treatment on frequency, extent and speed of coronary atherosclerosis development after and without operation. The research included 243 patients, among them 103 patients after coronary stenting, 105 patients with coronary bypass without extracorporeal circulation and 35 patients after coronary artery bypass grafting with extracorporeal circulation. The median follow-up period was 29 months. The research of 729 coronary arteries in 243 patients showed progression of coronary atherosclerosis (appearance of new and progression of “old” stenoses) in 363 vessels (49.8 %). After coronary bypass the progression of coronary atherosclerosis was evident in 183 (58.1 %) shunted coronary arteries without extracorporeal circulation and in 47 (44.8 %) shunted coronary arteries with extracorporeal circulation, as well as in 29 (9.4 %) stented arteries. In conclusion, coronary bypass, as a protracted traumatic factor, is associated with progression of coronary atherosclerosis in shunted coronary arteries five times more often than in patients after coronary stenting. It means that coronary stenting, as a transitory traumatic factor, influences less the progression of coronary atherosclerosis than coronary bypass grafting.

Full article