Risk of Cardiovascular Death in the Remote Period after Myocardial Revascularization and in Association with Renal Dysfunction

Abstract

The aim of the present study was to assess the effectiveness of standard medical therapy in lowering the risk of cardiovascular death in the remote period after myocardial revascularization (MR), taking into account the presence of renal dysfunction. Material and Methods: The study included 90 patients with coronary heart disease (CHD) and indications for revascularization. We evaluated a drug therapy obtained at different stages of revascularization, as well as the severity of patients' condition and the prevalence of renal dysfunction. Results: In the remote period after MR (5.8±0.05 years), 71/78.9% patients participated in the study; death occurred in 10/12.3% patients. The duration of therapy for chronic myocardial ischemia before MR (P=0.005), as well as compliance with prescribed therapy during 6 months (P=0.008) after this procedure, affected cardiovascular death in the remote period after MR. Using statins before MR reduced the risk of cardiovascular death by 17.2% (P=0.01), beta-blockers-14.95% (P=0.04), and ACE inhibitors (ACEIs)-15.75% (P=0.03). The lack of regular use of acetylsalicylic acid (ASA) for 6 months after RM was associated with an increase in the risk of cardiovascular death up to 36.2% (P=0.005). Statins and ACEIs are drugs that reduce the risk of cardiovascular death in the presence of renal dysfunction (P<0.05). Conclusion: An efficient drug regimen for patients after MR is important in reducing a long-term prognosis of cardiovascular death and for an efficient correction of coronary artery patency.