New Pharmacological Approach to Improvement of Quality of Life of Patients after Coronary Artery Bypass Grafting through Stimulation of Neoangiogenesis

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Abstract

INTRODUCTION: Despite the increased volume of rendered high-tech assistance and objective improvement of the condition of the majority of operated patients, the parameters of physical activity and working capacity in this category of patients remain low.

AIM: To study the effect of 5-oxymethyluracil with angiogenic properties on the quality of life of patients in the early and long-term period after coronary artery bypass grafting (CABG).

MATERIALS AND METHODS: The randomized prospective study included two groups of patients: the main group (n = 87) which in the perioperative period of CABG (5 days before and 14 days after surgery), in addition to standard therapy, received the drug 5-oxymethyluracil), and the control group (n = 81) which received standard therapy. The groups were comparable in gender, age, basic clinical and functional characteristics and peculiarities of surgical intervention. The quality of life of patients was determined by the Seattle Angina Questionnaire (SAQ) before CABG surgery (upon admission to the vascular surgery department) and after surgery (after 2 months and 16–18 years). There were no statistically significant differences in the preoperative parameters of quality of life in the control and main groups.

RESULTS: In the long-term period of surgical revascularization of the myocardium (16–18 years after the operation) the severity of angina according to SAQ was: in the control group — 33.30 (20.00-60.00), in the main group — 60.00 (33.30-70.00; р = 0.0407). Other scales of SAQ, including physical activity, stability of anginal course, satisfaction with treatment and perception of the disease, did not demonstrate any differences between the studied groups in 2 months or 16–18 years after CABG.

CONCLUSION: Perioperative use of 5-oxymethyluracil influenced the improvement of only one parameter of quality of life according to the SAQ questionnaire — the severity of angina, with statistically significant differences between the groups in the long-term period of CABG (16–18 years after surgery). According to SAQ questionnaire, there was no effect on the remaining parameters of the quality of life with the underlying perioperative use of the studied drug in all follow-up periods.

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About the authors

Bogdan A. Oleynik

Bashkir State Medical University

Author for correspondence.
Email: bogdan-ufa@mail.ru
ORCID iD: 0000-0002-4144-3946
SPIN-code: 9249-9187

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Ufa

Valer'yan A. Evdakov

Russian Research Institute of Health

Email: evdakov41@mail.ru
ORCID iD: 0000-0002-5836-4427
SPIN-code: 8294-2939

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Vladimir V. Plechev

Bashkir State Medical University

Email: angio02@mail.ru
ORCID iD: 0000-0002-6716-4048
SPIN-code: 2052-4587

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ufa

Ramil' I. Izhbul'din

Bashkir State Medical University

Email: doctor263@rambler.ru
ORCID iD: 0000-0001-6216-2935

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ufa

References

  1. Benjamin EJ, Muntner P, Alonso A, et al. Heart Disease and Stroke Statistics — 2019 Update: A Report From the American Heart Association. Circulation. 2020;141(2):e56–e528. doi: 10.1161/CIR.0000000000000659
  2. Muka T, Imo D, Jaspers L, et al. The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. European Journal of Epidemiology. 2015;30(4):251–77. doi: 10.1007/s10654-014-9984-2
  3. Kontsevaya AV, Drapkina OM, Balanova YuA, et al. Economic Burden of Cardiovascular Diseases in the Russian Federation in 2016. Rational Pharmacotherapy in Cardiology. 2018;14(2):156–66. (In Russ). doi: 10.20996/1819-6446-2018-14-2-156-166
  4. Neuman F–J, Sousa–Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. European Heart Journal. 2019;40(2):87–165. doi: 10.1093/eurheartj/ehy394
  5. Bokeriya LA, Miliyevskaya EB, Pryanishnikov VV, et al. Serdechno-sosudistaya khirurgiya — 2021. Bolezni i vrozhdennyye anomalii sistemy krovoobrashcheniya. Moscow; 2021. (In Russ).
  6. ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management. Russian Journal of Cardiology. 2015;(8):7–66. (In Russ). doi: 10.15829/1560-4071-2015-08-7-66
  7. Lubinskaya EI, Nikolaeva OB, Demchenko EA. Clinical and social effectiveness of comprehensive cardiac rehabilitation program in patient after coronary artery bypass surgery. Bulletin of the Russian Military Medical Academy. 2012;37(1):218–23. (In Russ).
  8. Ratova LG, Parizhskaya EN, Kovaleva KA, et al. An observational study to assess the outcomes of treatment of patients with stable angina after planned percutaneous coronary intervention: baseline patient characteristics. Russian Journal of Cardiology. 2018;(12):52–6. (In Russ). doi: 10.15829/1560-4071-2018-12-52-56
  9. Ratova LG, Parizhskaya EN, Kovaleva КA, et al. Evaluation of the outcomes of stable angina management after selective percutaneous coronary intervention (pilot results). Russian Journal of Cardiology. 2017;(12):8–13. (In Russ). doi: 10.15829/1560-4071-2017-12-8-13
  10. Nemyatykh OD, Kovaleva KA. Sotsial'no-ekonomicheskie aspekty lekarstvennogo obespecheniya patsientov s serdechno-sosudistymi patologiyami v postoperatsionnom periode. In: Sbornik materialov IV Vserossiiskoi nauchno-prakticheskoi konferentsii s mezhdunarodnym uchastiem «Innovatsii v zdorov'e natsii»: Saint-Petersburg, 9–10 November 2016. Saint-Petersburg; 2016. P. 445–7. (In Russ).
  11. Spertus JA, Winder JA, Dewhurst TA, et al. Development and evaluation of the Seattle Angina questionnaire: A new functional status measure for coronary artery disease. Journal of the American College of Cardiology. 1995;25(2):333–41. doi: 10.1016/0735-1097(94)00397-9
  12. Syrkin AL, Pechorina EA, Drinitsina SV. Quality of life determination in patients with ischemic heart disease-stable angina pectoris. Clinical Medicine. 1998;76(6):52–8. (In Russ).
  13. Spertus JA, Jones PG, Maron DJ, et al. Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease. The New England Journal of Medicine. 2020;382(15):1408–19. doi: 10.1056/NEJMoa1916370
  14. Creber RM, Dimagli A, Spadaccio C, et al. Effect of coronary artery bypass grafting on quality of life: a meta-analysis of randomized trials. European Heart Journal. Quality of Care & Clinical Outcomes. 2022;8(3):259–68. doi: 10.1093/ehjqcco/qcab075
  15. Simons M, Annex BH, Laham RJ, et al. Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2: double-blind, randomized, controlled clinical trial. Circulation. 2002;105(7):788–93. doi: 10.1161/hc0802.104407
  16. Giacca M, Zacchigna S. VEGF gene therapy: therapeutic angiogenesis in the clinic and beyond. Gene Therapy. 2012;19:622–9. doi: 10.1038/gt.2012.17
  17. Gaffney MM, Hynes SO, Barry F, et al. Cardiovascular gene therapy: current status and therapeutic potential. British Journal of Pharmacology. 2007;152(2):175–88. doi: 10.1038/sj.bjp.0707315
  18. Ylä–Herttuala S, Bridges C, Katz MG, et al. Angiogenic gene therapy in cardiovascular diseases: dream or vision? European Heart Journal. 2017;38(18):1365–71. doi: 10.1093/eurheartj/ehw547

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Dynamics of limitation of physical activity by the Seattle Angina Questionnaire after surgical myocardial revascularization, in % relative to preoperative values.

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3. Fig. 2. Dynamics of ‘anginal stability’ parameter by the Seattle Anginal Questionnaire after surgical myocardial revascularization, in % relative to preoperative values.

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4. Fig. 3. Dynamics of ‘anginal frequency’ parameter by the Seattle Angina Questionnaire after surgical myocardial revascularization, in % relative to the preoperative values.

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5. Fig. 4. Dynamics of ‘treatment satisfaction’ parameter by the Seattle Angina Questionnaire after surgical myocardial revascularization, in % relative to the preoperative values.

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6. Fig. 5. Dynamics of ‘disease perception’ parameter after surgical myocardial revascularization according to the Seattle Angina Questionnaire, in % relative to the preoperative values.

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