REGISTER OF PATIENTS WITH STABLE CORONARY ARTERY DISEASE UNDERWENT CORONARY ARTERY BYPASS GRAFTING SURGERY (RICOCHET PROGRAM)

Objective. The article presents the analysis of social, demographic and clinical risk factors, perioperative examination parameters, therapy and outcome data in patients with stable coronary artery coronary disease after coronary artery bypass grafting surgery (CABG) in three regions inRussian Federation during 2012 year in the context of Ricochet program. The other aim was to establish a correspondence of the findings to international myocardial revascularization guidelines.

 Design and methods. Altogether 300 patients (100 in each region) were chosen according to the inclusion/exclusion criteria, and all participants were given individual numbers. All data were registered in a special database “A registry of patients with stable coronary artery disease after coronary artery bypass grafting surgery”. Phone visits or office visits when necessary were scheduled in 12 months. Response rate was almost 100 %.

Results. It was shown that males dominated among patients. The female CABG rate was three times lower, though the most of them (90 %) had myocardial infarction in past in comparison with 73 % of patients among male group. The average patient age was 60–64 years and 43 % of them were invalids. Work-status analysis of pre- and postoperative periods showed no significant difference. Indications for surgery correspond to current guidelines, however, the preoperative stress test rate was only 36 %.

Conclusions. The majority of patients were treated with evidence-based medicine drugs. A significant number of patients with recurrent angina after CABG, including high functional class, was found. These data indicate the need for an out-patient follow-up system for patients undergoing CABG, including cardiac rehabilitation, therapy correction, and, if necessary, re-intervention.

1. Information in the socio-economic situation in Russia. 2013. Federal State Statistics Serviсe. URL: www.gksrussian. (Информация о социально-экономическом положении России — 2013. Федеральная служба государственной статистики. www.gks.ru/bgd/free/B13_00/Mainhtm)

2. World health report 2008 World Health Organization website URL; apps.who.int/gho/data/mademain

3. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ et al Heart disease and stroke statistics — 2014 update; a report from American Heart Association. Circulation. 2014;129(3):e28–292.

4. Shalnova SA, Konradi AO, Karpov YA et al. Cardiovascular mortality in 12 Russian Federation regions — participants of the “Cardiovascular Disease epidemiology in Russian Regions” Study. Russ J Cardiol. 2013;97:6–11. In Russian.

5. Bokeria LI. Calculation of the need in cardiothoracic surgery and its optimization. Health-care System in Russian Federation. 2008;4:24–7. In Russian.

6. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use appropriate use criteria for coronary revascularization focused update. J Am Coll Cardiol. — online Jan 30, 2012. — doi:10.1016/j.jacc.2011.12.001 Chan PS, Pater MR, Klein LW et al. Appropriateness of percutaneous coronary intervention. J Am Med Assoc. 2011;306(1):53–61.

7. Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/AHA/ASNC/ HFSA/ SCCT 2012 Appropriate use criteria for coronary revascularization focused update. J Am Coll Cardiol. 2012;59(9):857–81.

8. Wijns W, Kolh P, Danchin N et al. Guidelines on myocardial revascularization The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European association for cardio-thoracic surgery (EACTS). Eur Heart J. 2010;31(20):2501–55.

9. Hallberg V, Palomaki A, Kataija M, Tarkka M. Return to work after coronary artery bypass surgery A10-year follow-up study. Scand Cardiovasc J. 2008;8:1–6.

10. Brown ML, Gersh BJ, Holmes DR, Bailey KR, 3rd. From randomized trials to registry studies: translating data into clinical information. Nat Clin Pract Cardiovasc Med. 2008;5(10):613–20.

11. Efros LA, Samorodskaya IV. Social and demographic characteristics and long-term survival assessment in patients underwent coronary artery bypass surgery depending on disability. Electronic Scientific J. 18.04.2013. In Russian.

12. Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress. Does stress account for SES effects on health? Ann NY Acad Sci. 1999;896: 131–144.

13. Mattioli AV, Bonatti S, Zennaro M, Mattioli G. The relationship between personality, socio-economic factors, acute life stress and the development, spontaneous conversion and recurrences of acute lone atrial fibrillation. Europace. 2005;7(3):211–220.

14. Perk J, Alexanderson K. Sick leave due to coronary artery disease or stroke. Scand J Public Health. 2004;32(63):S181–206.

15. Yancy CW, Fonarow GC, Albert NM et al. Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: fin dings from IMPROVE HF. Am Heart J. 2009;157(4):754–62.

16. Kim D. Medicare payment reform and hospital costs: evidence from the prospective payment system and the treatment of cardiac disease. November 20. 2011. JEL Codes: H51, I11, I18, L51.

17. Bhatt DL, Steg PG, Ohman EM et al. REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. J Am Med Assoc. 2006;295(2):180–9.