CHOICE OF SURGICAL TREATMENT METHOD IN WOMEN WITH ISCHEMIC HEART DISEASE

Abstract

Ischemic heart disease (IHD) in women is characterized by specific features of pathophysiology, clinical course, and outcomes, which requires a differentiated approach to the selection of surgical treatment methods. The aim of the study was to develop a prognostic model for selecting a revascularization method (coronary artery stenting and aortocoronary bypass surgery) in women with IHD based on an analysis of comorbidities and clinical and instrumental data.

A retrospective study was conducted on 302 female patients with IHD. Analysis was performed of body mass index (BMI), coronary calcium score (CCIS), echocardiography, and spirometry data. It was found that overweight is associated with a higher likelihood of stenting (OR = 2.48; 95% CI 1.28–4.81), whereas obesity does not have a statistically significant effect. The most significant predictor of treatment choice is the CCS (χ² = 96.47; p < 0.001): with a CCI score of 0, the probability of stenting increases nearly 9-fold (OR = 8.80; 95% CI 4.42–17.51), whereas with a CCI score > 400, aortocoronary bypass surgery is predominantly performed.

The data obtained indicate the key role of coronary calcification and comorbid factors in the choice of revascularization strategy. The necessity of a multidisciplinary approach with mandatory assessment of CCI and the functional status of the respiratory system when planning surgical treatment of IHD in women is substantiated.