Long-term results
Telephone or clinical interviews were conducted in April 2021. For
staged operations’ groups, the assessment was carried out after both
stages of reconstructive interventions were performed. The maximum
follow–up time for the patient was 78 months, the minimum was 4 months.
Average follow-up time: 41.1±21.8 months. The endpoints were death from
all causes, ACVA, TIA, MI, as well as a combined endpoint, including
death from all causes, acute MI, ACVA, TIA during the patient’s
hospitalization.
We managed to contact 225 patients out of 243 operated (92.6%). We were
unable to find out long-term results in 3 patients from the staged
interventions’ group (the first stage of CABG), 7 patients from the
staged interventions’ group (the first stage of CEA) and 8 patients from
the combined interventions’ group. The overall survival rate was 93.8%
(92.9% for the stage group (the first stage of CABG), 93.3% for the
stage group (the first stage of CEA) and 94.8% for the combined
interventions’ group, p=0.807). 14 people died (6,2%) – 7 (7,1%) in
the group with the first stage of CABG, 2 (6.7%) in the group with the
first stage of CEA and 5 (5.2%) in the combined group. In total, 5
(2.4%) MI cases – 2 (9.1%) were recorded in the group with first
performed CABG, 1 (3.3%) in the group with first performed CEA and 2
(2.1%) in the combined group, and 11 (4.9%) ACVA cases – 4 (4.0%) in
the group with first performed CABG, 3 (10%) in the group with first
performed CEA and 4 (4.1%) in the simultaneous interventions’ group.
There was also 1 (1.0%) TIA case in the stage group (the first stage of
CABG). One person in the combined group died from MI, there weren’t
fatal cases from MI in the staged interventions’ group. 1 person died
from ACVA in both stage groups and 1 person in the combined group. The
combined point was 15 (15.2%) in the stage group (the first stage of
CABG), 5 (16.7%) in the stage group (the first stage of CEA) and 11
(10.6%) in the combined group. There weren’t identified significant
differences between groups in the any studied parameters and endpoints
(Table. IV).
In the analysis by Kaplan-Meier survival within 6 years in the
simultaneous interventions’ group represented 94.8% in the group stage
of the interventions (first stage CABG) – 92,9% in the group stage of
the interventions (the first stage of the CEA) – 93,3% with
corresponding 95% confidence intervals (Figure 2A). In the survival
analysis by logrank test isn’t statistically significant differences
(χ2=0,487, p=0,784).
The groups didn’t differ in terms of freedom from MI in the long-term
postoperative period (Figure 2B). For the combined group, this indicator
was 97.9%, for the stage group (the first stage of CABG) – 97.9%, for
the group of stage interventions (the first stage of CEA) – 96.7%
(χ2=0.013, p=0.994).
When analyzing the freedom from ACVA according to the logrank criterion,
there also weren’t differences between the groups (Figure 2C). Thus, the
indicator for the combined group was 95.8%, for the stage group (the
first stage of CABG) – 95.7%, for the stage group (the first stage of
CEA) - 90.0% (χ2=0.410, p=0.815).
When comparing the freedom from the combined endpoint complications
(mortality from all causes + MI+ACVA+TIA) by the Kaplan-Mayer method,
several events summation in one patient didn’t occur, but it was
believed that one complication occurred, due to this method’s
peculiarities. Freedom from the combined indicator development
(lethality from all causes + MI+ACVA+TIA) for 6 years was 91.7% for the
simultaneous interventions’ group, 87.9% for the group in which CABG
was performed at the first stage and 86.7% for the group in which the
first stage was performed CEA (χ2=0.952, p=0.621) (Figure 2D).