PHYSICAL FUNCTION IN PATIENTS WITH CORONARY ARTERY DISEASE IN LONG-TERM MYOCARDIAL SURGICAL REVASCULARIZATION AFTER PHARMACOLOGICAL STIMULATION OF NEOANGIOGENESIS

Purpose. To study the effect of a medication with angiogenic properties of 5-Oxymethyluracil on the functional class of angina and circulatory failure in long-term myocardial surgical revascularization.Material and methods. Two groups of patients have been included in a randomized prospective study as follows: the core group (comprised of 87 patients) has been obtaining 5-Oxymethyluracil medication in the perioperative period of coronary artery bypass graft (CABG) surgery (5 days prior to and within 14 days after the surgical procedure) in addition to standard medical therapy, and the control group (comprised of 81 patients) has been obtaining standard medical therapy. The groups were comparable in terms of a gender, age, principal clinical and functional specifications and features of surgery. The stable angina functional class (FC) was determined according to the classification of the Canadian Cardiovascular Society (CCS), and circulatory failure (CF) was determined according to the classification of the New York Heart Association (NYHA) in patients before surgery (upon admission to the vascular surgery department) and after surgery (after 2 months and after 15-17 years).Results. Preoperative values did not differ between the studied groups of patients (p=1.0). Within the period of 2 months after the CABG, the average angina FC amounted to 1.76 (1.0-2.0) in the control group, and to 1.53 (1.0-2.0) in the core group, the average CF FC amounted to 1.69 (1.0-2.0) in the control group; it amounted to 1.46 (1.0-2.0) in the core group. In the long-term period (16-18 years after operation) the angina FC amounted to 2.32 (2.0-3.0) in the control group, and 1.93 (1.0-2.0) in the core group; the CF FC amounted to 2.29 (2.0-3.0) in the control group, it amounted to 2.20 (2.0-2.0) in the core group. While comparing these values within the period of 2 months after the CABG, the average angina FC was 13.0% lower in the core group (p=0.0359) and 20.2% lower in 16-18 years postoperatively than in the control group (p=0.0303). Comparison of the average CF FCs within the period of 2 months and 16-18 years after the CABG showed no statistically significant differences in the groups studied.Conclusion. The use of 5-Oxymethyluracil in the perioperative period improves the angina functional class in the early postoperative period after coronary artery bypass grafting, and this effect is maintained throughout the follow-up period up to 18 years, while the medication does not significantly affect the functional class of circulatory failure during the entire follow-up period.

Coronary Artery Disease, coronary artery bypass graft, angiogenesis, functional class, angina, circulatory failure