Clinical and functional features of patients with acute coronary syndrome and history of coronary artery bypass grafting

Abstract

The aim – to investigate the clinical and functional parameters features in acute coronary syndrome and coronary artery bypass grafting history patients.Materials and methods. 68 patients with acute coronary syndrome (ACS) were examined according to the current protocols, in 30 of them there was a history of coronary artery bypass grafting (ACS and CABG group) and 38 patients who didn’t undergo CABG (ACS without CABG group). Physical and laboratory-instrumental methods of investigation, including ECG, echocardiography, coronary ventriculography, coronary artery bypass graft angiography and methods of variation statistics were used in the work.Results and discussion. Among patients with ACS and CABG, a history of a higher incidence and duration of stable angina pectoris, arterial hypertension, diabetes mellitus, and multiple concomitant pathology had been found in comparison with the ACS without CABG group. History of ACS and CABG patients comprised a higher incidence of ACS without ST segment elevation in comparison with ACS without CABG group, repeated ACS, heart failure progression and those patients needed significantly longer stay in ICU than ACS without CABG group. Electrocardiograms of patients with ACS and CABG vs ACS without CABG group were characterized by a significantly higher incidence of pathological Q, atrial and ventricular fibrillation, as well as a combined disturbances of rhythm and conduction. Echocardiography revealed a significantly lower ejection fraction, increase in left atrium size and an E/A ratio in the ACS and CABG group, indicating worse heart failure compensation as well as systolic and diastolic dysfunction with dysfunctional of left ventricular than in ACS without CABG patients.Conclusions. Acute coronary syndrome with coronary artery bypass grafting history patients are characterized by a complicated history and clinical course with more significant electrocardiogram and echocardiography changes in comparison to the group of acute coronary syndrome patients without prior coronary artery bypass grafting history.