Аналіз предикторів розвитку великих несприятливих серцевих і судинно-мозкових подій після реваскуляризації основного стовбура лівої коронарної артерії в пацієнтів похилого віку

The aim – to analyze the predictors of the development of major adverse cardiovascular and cerebrovascular events (MACCE)in the early period following revascularization of the left main coronary artery (LMCA) in elderly patients. Materials and methods. This retrospective study included 200 patients aged 60 to 75 years with ischemic heart disease (IHD) who underwent revascularization of the left main coronary artery between September 2021 and July 2024. Depending on the revascularization method, patients were divided into two groups: Group A – revascularization by means of percutaneous coronary intervention (PCI) (n = 150) and Group B – coronary artery bypass grafting (CABG) (n = 50). Results. In Group A, myocardial infarction during the hospital period occurred significantly less often (6.67 %, p = 0.017), and the incidence of MACCE was 16.0 % (p = 0.001) lower compared to Group B. Independent predictors for the development of MACCE in the early period after myocardial revascularization in elderly patients with LMCA disease included smoking (OR 12.2; 95 % CI 3.32–44.6, p = 0.001), presence of diabetes mellitus (OR 6.34; 95 % CI 2.20–18.3, p = 0.001), a history of PCI (OR 5.44; 95 % CI 1.85–16.0, p = 0.004), and left ventricular ejection fraction (LVEF) below 40 % (OR 5.72; 95 % CI 1.93–16.9, p = 0.003). The performance of PCI in elderly patients with LMCA disease and the presence of independent predictors such as smoking (p = 0.0001), history of PCI (p = 0.006), and LVEF < 40 % (p = 0.048) was associated with a significantly lower development of MACCE compared to CABG in this cohort of patients. Conclusions. Independent predictors for the development of MACCE in the early period after myocardial revascularization in elderly patients with LMCA disease included smoking, diabetes mellitus, a history of PCI, and an LVEF below 40 %.