FACTORS CONTRIBUTING TO CHOOSING PERCUTANEOUS CORONARY INTERVENTION OR CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH CORONARY ARTERY DISEASE

ABBAS MOHAMMED SADIQ  MIRZA; ABDULAZEEZ MOHSIN  ABDULAZEEZ

doi:10.26682/sjuod.2022.25.2.14

ABBAS MOHAMMED SADIQ MIRZA College of Nursing, University of Duhok, Kurdistan Region-Iraq
ABDULAZEEZ MOHSIN ABDULAZEEZ College of Medicine, University of Duhok, Kurdistan Region-Iraq

DOI: https://doi.org/10.26682/sjuod.2022.25.2.14

Keywords: Coronary artery disease, Coronary artery bypasses grafting, percutaneous coronary intervention.

Abstract

Introduction: Coronary artery disease is a heart disease that is the main cause of mortality in both developed and developing nations. Management of coronary artery disease by coronary artery bypass graft surgery has significant complications for patients. In this regard, we aimed to determine factors contributing to choosing percutaneous coronary intervention or coronary artery bypass graft in patients with coronary artery disease.

Methods: In this cross-sectional study, the patients who were diagnosed with coronary arteries disease who were admitted to rom Azadi Heart Canter and Vin Private Hospital Department of Cardiology in Duhok city from November 2021 to January 2022 were included. The coronary artery disease patients were of both genders aged 18 - 75 years with various socio-demographic characteristics who received percutaneous coronary intervention or coronary artery bypass graft were the target population of this study.

Results: The study found that the mean age of the patients was 58.2 between 34 and 75 years old. The majority of the study sample were male (66%). The study showed that smoking, BMI, and diabetes mellitus were the only predictors of receiving coronary artery bypass graft or percutaneous coronary intervention the coronary artery disease patients. Heavy smokers were 3.9 times more likely to receive percutaneous coronary intervention compared to non-smoker patients (95% CI 1.5-10.5, P=0.00061). In addition, the obese patients were 3.1 times more likely to receive coronary artery bypass graft compared to normal-weight patients (95% CI: 1.1-8.5: P=0.0259) and overweight compared to normal-weight patients (OR: 3.6 95%CI: 1.3-10.; P=0.0173). The diabetic patients were 0.6 times (60%) less likely to receive coronary artery bypass graft compared to non-diabetic patients.

Conclusions: The study showed that the patients who had diabetes mellitus and smokers were more likely to undergo the percutaneous coronary intervention. Being overweight and obese was shown to undergo the coronary artery bypass graft surgery rather than percutaneous coronary intervention

Downloads

Download data is not yet available.

References

Álvarez-Álvarez, MM, Zanetti, D, Carreras-Torres, R, Moral, P & Athanasiadis, G (2017). A survey of sub-Saharan gene flow into the Mediterranean at risk loci for coronary artery disease. European Journal of Human Genetics, 25(4): 472-476.
Ashwell, M & Clarke, G (2009). Obesity risk: importance of the waist-to-height ratio. Nursing Standard (through 2013), 23(41): 49.
Barrera, R, Shi, W, Amar, D, Thaler, HT, Gabovich, N, Bains, MS, et al. (2005). Smoking and timing of cessation: impact on pulmonary complications after thoracotomy. Chest, 127(6): 1977-1983.
Barsness, GW, Peterson, ED, Ohman, EM, Nelson, CL, DeLong, ER, Reves, JG, et al. (1997). Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty. Circulation, 96(8): 2551-2556.
Bazzano, LA, He, J, Muntner, P, Vupputuri, S & Whelton, PK (2003). Relationship between cigarette smoking and novel risk factors for cardiovascular disease in the United States. Annals of internal medicine, 138(11): 891-897.
Bermúdez, VJ, Rojas, JJ, Córdova, EB, Añez, R, Toledo, A, Aguirre, MA, et al. (2013). International physical activity questionnaire overestimation is ameliorated by individual analysis of the scores. American journal of therapeutics, 20(4): 448-458.
Booth, J, Clayton, T, Pepper, J, Nugara, F, Flather, M, Sigwart, U, et al. (2008). Randomized, controlled trial of coronary artery bypass surgery versus percutaneous coronary intervention in patients with multivessel coronary artery disease: six-year follow-up from the Stent or Surgery Trial (SoS). Circulation, 118(4): 381-388.
Charlson, M, Szatrowski, TP, Peterson, J & Gold, J (1994). Validation of a combined comorbidity index. Journal of clinical epidemiology, 47(11): 1245-1251.
Christofferson, RD, Lehmann, KG, Martin, GV, Every, N, Caldwell, JH & Kapadia, SR (2005). Effect of chronic total coronary occlusion on treatment strategy. The American journal of cardiology, 95(9): 1088-1091.
Doughty, M, Mehta, R, Bruckman, D, Das, S, Karavite, D, Tsai, T, et al. (2002). Acute myocardial infarction in the young—The University of Michigan experience. American heart journal, 143(1): 56-62.
Farkouh, ME, Dangas, G, Leon, MB, Smith, C, Nesto, R, Buse, JB, et al. (2008). Design of the Future REvascularization Evaluation in patients with Diabetes mellitus: Optimal management of Multivessel disease (FREEDOM) Trial. American heart journal, 155(2): 215-223.
Fefer, P, Knudtson, ML, Cheema, AN, Galbraith, PD, Osherov, AB, Yalonetsky, S, et al. (2012). Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. Journal of the American College of Cardiology, 59(11): 991-997.
Feit, F, Brooks, MM, Sopko, G, Keller, NM, Rosen, A, Krone, R, et al. (2000). Long-term clinical outcome in the Bypass Angioplasty Revascularization Investigation Registry: comparison with the randomized trial. Circulation, 101(24): 2795-2802.
Gürbüz, HA, Durukan, AB, Salman, N, Uçar, H & Yorgancıoğlu, C (2014). Obesity is still a risk factor in coronary artery by-pass surgery. Anadolu Kardiyol Derg doi, 10(
Hammal, F, Ezekowitz, JA, Norris, CM, Wild, TC & Finegan, BA (2014). Smoking status and survival: impact on mortality of continuing to smoke one year after the angiographic diagnosis of coronary artery disease, a prospective cohort study. BMC Cardiovascular Disorders, 14(1): 1-9.
Hollenbeak, CS, Murphy, DM, Koenig, S, Woodward, RS, Dunagan, WC & Fraser, VJ (2000). The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery. Chest, 118(2): 397-402.
Jiang, J, Teng, Y, Fan, Z, Khan, S & Xia, Y (2014). Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis. Clinical Orthopaedics and Related Research®, 472(3): 968-975.
Khullar, D & Maa, J (2012). The impact of smoking on surgical outcomes. Journal of the American College of Surgeons, 215(3): 418-426.
Kim, LJ, King, SB, Kent, K, Brooks, MM, Kip, KE, Abbott, JD, et al. (2009). Factors related to the selection of surgical versus percutaneous revascularization in diabetic patients with multivessel coronary artery disease in the BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes) trial. JACC: Cardiovascular Interventions, 2(5): 384-392.
Koechlin, L, Zenklusen, U, Doebele, T, Rrahmani, B, Gahl, B, Schaeffer, T, et al. (2020). Analysis of myocardial ischemia parameters after coronary artery bypass grafting with minimal extracorporeal circulation and a novel microplegia versus off-pump coronary artery bypass grafting. Mediators of inflammation, 2020(
Ma, WQ, Sun, XJ, Wang, Y, Han, XQ, Zhu, Y & Liu, NF (2018). Does body mass index truly affect mortality and cardiovascular outcomes in patients after coronary revascularization with percutaneous coronary intervention or coronary artery bypass graft? A systematic review and network meta‐analysis. Obesity reviews, 19(9): 1236-1247.
Mirzaie, M, Khajedaluee, M, Falsoleiman, H, Mirzaie, A, Emadzadeh, MR & Taghvaei, MRE (2015). Demographic and socioeconomic factors of patients with coronary artery diseases undertreatment of coronary artery bypass grafting, percutaneous coronary intervention and drug therapy in Mashhad, Iran. Iranian Red Crescent Medical Journal, 17(6).
Mohammad, AM, Jehangeer, HI & Shaikhow, SK (2015). Prevalence and risk factors of premature coronary artery disease in patients undergoing coronary angiography in Kurdistan, Iraq. BMC cardiovascular disorders, 15(1): 1-6.
Mulukutla, SR, Gleason, TG, Sharbaugh, M, Sultan, I, Marroquin, OC, Thoma, F, et al. (2019). Coronary bypass versus percutaneous revascularization in multivessel coronary artery disease. The Annals of thoracic surgery, 108(2): 474-480.
Neumann, F, Sousa-Uva, M, Ahlsson, A, Alfonso, F, Banning, A, Benedetto, U, et al. (2019). Zembala MO; ESC scientific document group. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J, 40(2): 87-165.
Oreopoulos, A, McAlister, FA, Kalantar-Zadeh, K, Padwal, R, Ezekowitz, JA, Sharma, AM, et al. (2009). The relationship between body mass index, treatment, and mortality in patients with established coronary artery disease: a report from APPROACH. European heart journal, 30(21): 2584-2592.
Ramanathan, K, Abel, JG, Park, JE, Fung, A, Mathew, V, Taylor, CM, et al. (2017). Surgical versus percutaneous coronary revascularization in patients with diabetes and acute coronary syndromes. Journal of the American College of Cardiology, 70(24): 2995-3006.
Serruys, PW, Morice, M-C, Kappetein, AP, Colombo, A, Holmes, DR, Mack, MJ, et al. (2009). Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. New England journal of medicine, 360(10): 961-972.
Sharmeen, L & Mark, C (2008). Anaesthesia and morbid obesity. Contin Educ Anaesth Crit Care Pain, 8(5): 151-156.
Shemirani, H & Separham, K (2007). The relative impact of smoking or Hypertension on severity of premature coronary artery disease.
Smith Jr, SC, Faxon, D, Cascio, W, Schaff, H, Gardner, T, Jacobs, A, et al. (2002). Prevention conference VI: diabetes and cardiovascular disease: writing group VI: revascularization in diabetic patients. Circulation, 105(18): e165-e169.
Tarantini, G, Ramondo, A, Napodano, M, Favaretto, E, Gardin, A, Bilato, C, et al. (2009). PCI versus CABG for multivessel coronary disease in diabetics. Catheterization and Cardiovascular Interventions, 73(1): 50-58.