Why the study?
Progressive vascular calcification with age independently predicts cardiovascular complications and poses significant challenges in selecting the optimal strategy for endovascular revascularization in elderly and senile patients with coronary heart disease.
Observational (n=253)
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Retrospective study shows endovascular intervention reduces angina without altering mortality in elderly patients with calcified coronary disease, suggesting improved quality of life.
BACKGROUND: In the context of a steadily aging population and a progressive increase in the incidence of cardiovascular diseases, coronary heart disease with coronary artery calcification is a critical issue in modern cardiology. The progressive calcification of the vascular bed with age not only serves as an independent predictor of cardiovascular complications but also poses significant challenges in selecting the optimal strategy for endovascular revascularization in patients in older age groups. AIM: To conduct a retrospective analysis of the effectiveness of treatment in patients with coronary heart disease and coronary artery calcification in elderly and senile age. METHODS: We analyzed clinical data and quality-of-life indicators in two groups of patients: group 1 (main) with endovascular intervention and group 2 (comparison) with drug therapy alone. The level of calcified vascular lesions was determined using coronary angiography and a method for selecting treatment tactics (Patent RU2831567C1). RESULTS: The groups were comparable by functional class of angina: functional class III, 97 (83.6%) and 114 (83.2%) patients in groups 1 and 2, respectively; functional class IV, 19 (16.4%) and 23 (16.8%) patients; by sex: men, 82 (70.7%) and 96 (70.1%) patients; women, 34 (29.3%) and 41 (29.9%) patients; by age: 72 ± 8.9 and 73 ± 8.1 years. Both groups were comparable in terms of the main selection criteria but differed in terms of the presence of obesity: the body mass index was 27.9 ± 1.8 and 29.1 ± 1.6 kg/m², respectively, in groups 1 and 2. The groups were comparable by the presence of concomitant diseases: arterial hypertension, 61 (52.6%) and 95 (69.3%) patients; diabetes mellitus, 41 (35.3%) and 84 (61.3%) patients; smoking, 44 (37.9%) and 77 (56.2%) patients in groups 1 and 2, respectively. In the long-term follow-up, the mortality rate of patients in both groups did not differ significantly. In the main group, there was a decrease in the angina class (φemp = 2.329; p = 0.05). The probability of adverse cardiovascular complications and the risk of restenosis had a small but statistically significant intergroup difference (φemp = 2.049 and φemp = 2.088, respectively; p = 0.05). CONCLUSION: The degree of coronary calcification in the conservative therapy group was associated with a significantly higher incidence of diabetes, hypertension, and smoking in these patients compared with the main group. Despite the lack of impact on overall survival, endovascular treatment allows for significant improvement in physical activity and psychoemotional status, which is critically important for prolonging active longevity and improving the quality of life of patients of elderly and senile age.
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Fedorov et al. (2026) conducted an observational in Coronary heart disease with coronary artery calcification (n=253). Endovascular intervention vs. Drug therapy alone was evaluated on Angina functional class, adverse cardiovascular complications, and restenosis (φemp = 2.329, p=0.05).
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