Русский
Impact of coronary artery stenting on the course of chronic kidney disease in patients with stable angina
DOI: https://dx.doi.org/10.18565/pharmateca.2022.13.74-79
B.G. Iskenderov, A.V. Zaitseva, I.N. Mozhzhukhin, M.G. Ivanchukova
Department of Therapy, Cardiology, Functional Diagnostics and Rheumatology; Department of Radiology, Penza Institute for Postgraduate Medical Education – Branch Campus of the Russian Medical Academy of Continuous Professional Education, Penza, Russia
Background. Comorbidity of cardiovascular diseases and kidney dysfunction is common in the population. Dueto the widespread introduction of interventional treatment of coronary artery disease (CAD), the study of the effect of myocardial revascularization on the prognosis of patients with chronic kidney disease (CKD) is of current importance.
Objective. Evaluation of the effect of coronary artery stenting (CAS) on the course of CKD and analysis of cardiac events in patients with stable angina.
Methods. 122 patients (80 men and 42 women) aged 54 to 67 years (mean age 60.5±6.4 years) with coronary artery disease in combina- tion with stage 2 and 3a CKD were examined. Of these, 75 patients underwent CAS (Group 1), and 47 did not (Group 2). Clinical and instru- mental examination was performed at baseline, 3 and 9 months after the start of the study. Patients underwent Doppler echocardiography, as well as assessment of the endothelium-dependent vasodilation, impaired local myocardial contractility, and exercise tolerance.
Results. It was found that in patients with multivessel coronary artery lesions, the glomerular filtration rate (GFR) was lower on average
by 29.7% (P<0.001), and the blood creatinine level was higher by 11.7% (P=0.013) than in patients with damage to one coronary artery. It was shown that in the 1st group, the implementation of CAS starting from the 3rd month after the procedure is accompanied by an improvement not only in hemodynamic parameters and an increase in exercise tolerance, but also by a significant increase in GFR and a decrease in the blood creatinine level. In addition, in the 1st group during the follow-up period, the development of acute coronary syndrome and the progression of CKD were detected much less frequently than in the 2nd group: 2.7 vs. 6.4% and 4.0 vs. 12.8%, respectively.
Conclusion. Thus, in patients with stable angina and comorbid CKD, CAS improves the functional state of the kidneys and reduces the frequency of cardiac events.
Objective. Evaluation of the effect of coronary artery stenting (CAS) on the course of CKD and analysis of cardiac events in patients with stable angina.
Methods. 122 patients (80 men and 42 women) aged 54 to 67 years (mean age 60.5±6.4 years) with coronary artery disease in combina- tion with stage 2 and 3a CKD were examined. Of these, 75 patients underwent CAS (Group 1), and 47 did not (Group 2). Clinical and instru- mental examination was performed at baseline, 3 and 9 months after the start of the study. Patients underwent Doppler echocardiography, as well as assessment of the endothelium-dependent vasodilation, impaired local myocardial contractility, and exercise tolerance.
Results. It was found that in patients with multivessel coronary artery lesions, the glomerular filtration rate (GFR) was lower on average
by 29.7% (P<0.001), and the blood creatinine level was higher by 11.7% (P=0.013) than in patients with damage to one coronary artery. It was shown that in the 1st group, the implementation of CAS starting from the 3rd month after the procedure is accompanied by an improvement not only in hemodynamic parameters and an increase in exercise tolerance, but also by a significant increase in GFR and a decrease in the blood creatinine level. In addition, in the 1st group during the follow-up period, the development of acute coronary syndrome and the progression of CKD were detected much less frequently than in the 2nd group: 2.7 vs. 6.4% and 4.0 vs. 12.8%, respectively.
Conclusion. Thus, in patients with stable angina and comorbid CKD, CAS improves the functional state of the kidneys and reduces the frequency of cardiac events.
About the Autors
Corresponding author: Bakhram G. Iskenderov, Dr. Sci. (Med.), Professor at the Department of Therapy, Cardiology, Functional Diagnostics and Rheumatology, Penza Institute for Postgraduate Medical Education – Branch Campus of the Russian Medical Academy of Continuous Professional Education, Penza, Russia; iskenderovbg@mail.ru
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