Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования
Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования
Базылев В.В., Немченко Е.В., Сластин Я.С. и др. Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования. CardioСоматика. 2018; 9 (1): 5–9. DOI: 10.26442/2221-7185_2018.1.5-9
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Bazylev V.V., Nemchenko E.V., Slastin Ya.S. The relationship between the SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting. Cardiosomatics. 2018; 9 (1): 5–9. DOI: 10.26442/2221-7185_2018.1.5-9
Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования
Базылев В.В., Немченко Е.В., Сластин Я.С. и др. Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования. CardioСоматика. 2018; 9 (1): 5–9. DOI: 10.26442/2221-7185_2018.1.5-9
________________________________________________
Bazylev V.V., Nemchenko E.V., Slastin Ya.S. The relationship between the SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting. Cardiosomatics. 2018; 9 (1): 5–9. DOI: 10.26442/2221-7185_2018.1.5-9
Цель – выявить взаимосвязь между баллом SYNTAX score и развитием послеоперационной фибрилляции предсердий (ФП). Материалы и методы. В ретроспективное исследование включены 156 пациентов (средний возраст 59±7 лет), подвергшихся изолированному коронарному шунтированию (КШ). Критериями исключения являлись: ФП в анамнезе, поражения клапанного аппарата сердца, диаметр левого предсердия более 50 мм, повторные оперативные вмешательства на сердце. Были оценены SYNTAX score, клинические, лабораторные и эхокардиографические параметры. Результаты. Средний балл SYNTAX score составил 26,7; постоперационная ФП выявлена у 23 (14,7%) пациентов. Статистически значимые отличия выявлены во времени искусственной вентиляции легких (10,6±5,9 в сравнении с 21,6±33,5, p=0,001) и SYNTAX score-оценкой (25,7±8,7 против 32,7±11,4, р=0,001). SYNTAX score и время искусственной вентиляции легких являются независимыми предикторами возникновения послеоперационной ФП. Вывод. Высокий балл SYNTAX score связан с более частым послеоперационным нарушением ритма по типу ФП у пациентов, подвергающихся изолированному КШ.
The goal is to reveal the relationship between the score SYNTAX score and the development of postoperative atrial fibrillation (AF). Materials and methods. Retrospective study included 156 patients (mean age 59±7 years) undergoing an isolated coronary bypass (CB). Exclusion criteria were: AF in the anamnesis, lesions of the valvular heart apparatus, diameter of the left atrium more than 50 mm, repeated surgical interventions on the heart. SYNTAX score, clinical, laboratory and echocardiographic parameters were evaluated. Results. The average score of the SYNTAX score was 26.7; postoperative AF was detected in 23 (14.7%) patients. Statistically significant differences were revealed during the time of mechanical ventilation (10.6±5.9 in comparison with 21.6±33.5, p=0.001) and SYNTAX score (25.7±8.7 vs 32.7±11.4, p=0.001). SYNTAX score and time of artificial ventilation are independent predictors of postoperative AF. Conclusion: a high score SYNTAX score is associated with a more frequent postoperative rhythm disturbance in the type of AF in patients undergoing an isolated CB.
1. Halpin LS, Barnett SD, Burton NA et al. National databases and clinical practice specialist: decreas-ing postoperative atrial fibrillation following cardiac surgery. Outcomes Manage 2004; 8: 33–8.
2. Ad N, Barnett SD, Haan CK et al. Does preoperative atrial fibrillation increase the risk for mortality and morbidity after coronary artery bypass grafting? Thorac Cardiovasc Surg 2009; 137: 901–6.
3. Rogers CA, Angelini GD, Culliford LA et al. Coronary surgery in patients with preexisting chronic atrial fibrillation: early and midterm clinical outcome. Thorac Surg 2006; 81: 1676–82.
4. Maesen B et al. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2012; 14 (2): 159–74. DOI: 10.1093/ europace/eur208
5. Funk M et al. Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Critical Care 2003; 12 (5): 424–33.
6. Peretto G et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract 2014; 2014: 615987.
7. Aranki SF, Shaw DP, Adams DH et al. Predictors of atrial fibrillation after coronary artery surgery. Current trends and impact on hospital resources. Circulation 1996; 94: 390–7.
8. Бокерия О.Л., Канаметов Т.Н. Послеоперационная фибрилляция предсердий: роль воспалительных цитокинов и использование колхицина как профилактического средства. Неинвазивная кардиология. 2015; 3 (2): 141–51. / Bokeriya O.L., Kanametov T.N. Posleoperatsionnaia fibrilliatsiia predserdii: rol' vospalitel'nykh tsitokinov i ispol'zovanie kolkhitsina kak profilakticheskogo sredstva. Neinvazivnaia kardiologiia. 2015; 3 (2): 141–51. [in Russian]
9. Tongtong Sh, Qijun Sh, Biao Yu et al. Predictors of post coronary artery bypass grafting atrial fibrillation. NMU Natural Sciences 2007; 3 (15): 139–142.
10. Sianos G, Morel MA, Kappetein AP et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention 2005; 1: 219–27.
11. Capodanno D. Syntax score: reaching optimal revascularization far complex coronary artery disease. Syntax score: reaching optimal revascularization far complex coronary artery disease. ESC Council Cardiology Practice 2009; 8 (5).
12. Valgimigli M, Serruys PW, Tsuchida K et al Cyphering the complexity of coronary artery disease using the SYNTAX score to predict clinical outcome in patients with three-vessel lumen obstruction undergoing percutaneous coronary intervention. Am J Cardiol 2007; 99: 1072–81.
13. Lemesle G, Bonello L, de Labriolle A et al. Prognostic value of the SYNTAX score in patients undergoing coronary artery bypass grafting for three-vessel coronary artery disease. Catheter Cardiovasc Interv 2009; 73: 612–7.
14. Capodanno D, Di Salvo ME, Cincotta G et al. Usefulness of the SYNTAX score for predicting clinical outcome after percutaneous coronary intervention of unprotected left main coronary artery disease. Circ Cardiovasc Interv 2009; 2: 302–8.
15. Birim O, van Gameren M, Bogers AJ. Complexity of coronary vasculature predicts outcome of surgery for left main disease. AP Ann Thorac Surg 2009; 87: 1097–104.
16. Serruys PW, Onuma Y, Garg S et al. Assessment of the SYNTAX score in the SYNTAX study. Euro Intervention 2009; 5: 50–6.
17. Fukui T, Uchimuro T, Takanashi S. Euro SCORE II with SYNTAX score to assess risks of coronary artery bypass grafting outcomes. Eur J Cardiothorac Surg 2015; 47: 66–71.
18. Windecker S, Kolh P, Alfonso F, Collet J. 2014 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2014; 35: 2541–619.
19. Ozaydın M, Dede O, Varol E et al. Effect of renin-angiotensin aldosteron system blockers on postoperative atrial fibrillation. Int J Cardiol 2008; 127: 362–7.
20. Sanjuan R, Blasco M, Carbonell N et al. Preoperative use of sotalol versus atenolol for atrial fibrillation after cardiac surgery. Ann Thorac Surg 2004; 77: 838–43.
21. Maisel WH, Klersy C, Zanobini M et al. Atrial fibrillation after cardiac surgery. Ann Intern Med 2001; 135: 1061–73.
22. Mariscalco G. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation 2008; 118: 1612–8.
23. Mariscalco G, Engstrom KG. Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery. Ann Thorac Surg 2009; 88: 1871–6.
24. Almassi GH, Schowalter T, Nicolosi AC et al. Atrial fibrillation after cardiac surgery: a major morbid event? Ann Surg 1997; 226: 501–11.
25. Mathew JP, Fontes ML, Tudor IC et al. Investigators of the Ischemia Research and Education Foundation; Multicenter Study of Perioperative Ischemia Research Group. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 2004; 291: 1720–9.
26. Walsh SR, Fontes ML, Tudor IC et al. Postoperative arrhythmias in general surgical patients. Ann R Coll Surg Engl 2007; 89: 91–5.
27. Carnero-Alcazar M, Maroto Castellanos LC, Silva Guisasola JA et al. SYNTAX Score is associated with worse outcomes after off-pump coronary artery bypass grafting surgery for three-vessel or left main complex coronary disease. J Thorac Cardiovasc Surg 2011; 142: 123–32.
28. Sianos G, Morel MA, Kappetein AP et al. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention 2005; 1: 219–27.
29. Rodrigo R, Korantzopoulos P, Cereceda M et al A randomized controlled trial to prevent postoperative atrial fibrillation by antioxidant reinforcement. J Am Coll Cardiol 2013; 62: 1457–65.
________________________________________________
1. Halpin LS, Barnett SD, Burton NA et al. National databases and clinical practice specialist: decreas-ing postoperative atrial fibrillation following cardiac surgery. Outcomes Manage 2004; 8: 33–8.
2. Ad N, Barnett SD, Haan CK et al. Does preoperative atrial fibrillation increase the risk for mortality and morbidity after coronary artery bypass grafting? Thorac Cardiovasc Surg 2009; 137: 901–6.
3. Rogers CA, Angelini GD, Culliford LA et al. Coronary surgery in patients with preexisting chronic atrial fibrillation: early and midterm clinical outcome. Thorac Surg 2006; 81: 1676–82.
4. Maesen B et al. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2012; 14 (2): 159–74. DOI: 10.1093/ europace/eur208
5. Funk M et al. Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Critical Care 2003; 12 (5): 424–33.
6. Peretto G et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract 2014; 2014: 615987.
7. Aranki SF, Shaw DP, Adams DH et al. Predictors of atrial fibrillation after coronary artery surgery. Current trends and impact on hospital resources. Circulation 1996; 94: 390–7.
8. Bokeriya O.L., Kanametov T.N. Posleoperatsionnaia fibrilliatsiia predserdii: rol' vospalitel'nykh tsitokinov i ispol'zovanie kolkhitsina kak profilakticheskogo sredstva. Neinvazivnaia kardiologiia. 2015; 3 (2): 141–51. [in Russian]
9. Tongtong Sh, Qijun Sh, Biao Yu et al. Predictors of post coronary artery bypass grafting atrial fibrillation. NMU Natural Sciences 2007; 3 (15): 139–142.
10. Sianos G, Morel MA, Kappetein AP et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention 2005; 1: 219–27.
11. Capodanno D. Syntax score: reaching optimal revascularization far complex coronary artery disease. Syntax score: reaching optimal revascularization far complex coronary artery disease. ESC Council Cardiology Practice 2009; 8 (5).
12. Valgimigli M, Serruys PW, Tsuchida K et al Cyphering the complexity of coronary artery disease using the SYNTAX score to predict clinical outcome in patients with three-vessel lumen obstruction undergoing percutaneous coronary intervention. Am J Cardiol 2007; 99: 1072–81.
13. Lemesle G, Bonello L, de Labriolle A et al. Prognostic value of the SYNTAX score in patients undergoing coronary artery bypass grafting for three-vessel coronary artery disease. Catheter Cardiovasc Interv 2009; 73: 612–7.
14. Capodanno D, Di Salvo ME, Cincotta G et al. Usefulness of the SYNTAX score for predicting clinical outcome after percutaneous coronary intervention of unprotected left main coronary artery disease. Circ Cardiovasc Interv 2009; 2: 302–8.
15. Birim O, van Gameren M, Bogers AJ. Complexity of coronary vasculature predicts outcome of surgery for left main disease. AP Ann Thorac Surg 2009; 87: 1097–104.
16. Serruys PW, Onuma Y, Garg S et al. Assessment of the SYNTAX score in the SYNTAX study. Euro Intervention 2009; 5: 50–6.
17. Fukui T, Uchimuro T, Takanashi S. Euro SCORE II with SYNTAX score to assess risks of coronary artery bypass grafting outcomes. Eur J Cardiothorac Surg 2015; 47: 66–71.
18. Windecker S, Kolh P, Alfonso F, Collet J. 2014 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2014; 35: 2541–619.
19. Ozaydın M, Dede O, Varol E et al. Effect of renin-angiotensin aldosteron system blockers on postoperative atrial fibrillation. Int J Cardiol 2008; 127: 362–7.
20. Sanjuan R, Blasco M, Carbonell N et al. Preoperative use of sotalol versus atenolol for atrial fibrillation after cardiac surgery. Ann Thorac Surg 2004; 77: 838–43.
21. Maisel WH, Klersy C, Zanobini M et al. Atrial fibrillation after cardiac surgery. Ann Intern Med 2001; 135: 1061–73.
22. Mariscalco G. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation 2008; 118: 1612–8.
23. Mariscalco G, Engstrom KG. Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery. Ann Thorac Surg 2009; 88: 1871–6.
24. Almassi GH, Schowalter T, Nicolosi AC et al. Atrial fibrillation after cardiac surgery: a major morbid event? Ann Surg 1997; 226: 501–11.
25. Mathew JP, Fontes ML, Tudor IC et al. Investigators of the Ischemia Research and Education Foundation; Multicenter Study of Perioperative Ischemia Research Group. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 2004; 291: 1720–9.
26. Walsh SR, Fontes ML, Tudor IC et al. Postoperative arrhythmias in general surgical patients. Ann R Coll Surg Engl 2007; 89: 91–5.
27. Carnero-Alcazar M, Maroto Castellanos LC, Silva Guisasola JA et al. SYNTAX Score is associated with worse outcomes after off-pump coronary artery bypass grafting surgery for three-vessel or left main complex coronary disease. J Thorac Cardiovasc Surg 2011; 142: 123–32.
28. Sianos G, Morel MA, Kappetein AP et al. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention 2005; 1: 219–27.
29. Rodrigo R, Korantzopoulos P, Cereceda M et al A randomized controlled trial to prevent postoperative atrial fibrillation by antioxidant reinforcement. J Am Coll Cardiol 2013; 62: 1457–65.
Federal Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation. 440071, Russian Federation, Penza, ul. Stasova, d. 6 *galana2004@mail.ru