cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2021-36-3-35-44cardiotomsk-1239Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОтдаленные результаты коронарного шунтирования у мужчин и женщин: влияние фактора пола (обзор литературы)Long-term results of coronary artery bypass grafting in men and women: Impact of gender factor (Review)https://orcid.org/0000-0002-8362-5676ПотеевМ. А.PoteevM. A.

Потеев Мансур Алиевич, врач сердечно-сосудистый хирург, отделение сердечно-сосудистой хирургии.

423803, Республика Татарстан, Набережные Челны, Набережночелнинский пр., 18

Mansur A. Poteev, Cardiovascular Surgeon, Department of Cardiovascular Surgery.

18, Naberezhnye Chelny ave., Naberezhnye Chelny, 423803, Republic of Tatarstan

poteev-astra@mail.ruhttps://orcid.org/0000-0003-3210-8174СтогнийН. Ю.StogniyN. Yu.

Стогний Никита Юрьевич, кандидат медицинских наук, врач сердечно-сосудистый хирург, заведующий отделением кардиохирургии № 1.

625023, Тюмень, ул. Котовского, 55

Nikita Yu. Stogniy, Cand. Sci. (Med.), Cardiovascular Surgeon, Chief of Department of Cardiovascular Surgery.

55, Kotovsky str., Tyumen, 625023

stogniinikita@gmail.comБольница скорой медицинской помощиРоссияEmergency HospitalRussian FederationОбластная клиническая больница № 1РоссияRegional Clinical Hospital No. 1Russian Federation2021061020213633544Copyright © Потеев М.А., Стогний Н.Ю., 20212021Потеев М.А., Стогний Н.Ю.Poteev M.A., Stogniy N.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/1239

Изучение отдаленных результатов коронарного шунтирования (КШ) в зависимости от пола пациента является актуальной проблемой современной кардиологии и кардиохирургии на протяжении последних трех десятилетий. Ряд авторов относят женский пол к независимым факторам риска неблагоприятных исходов в отдаленном периоде наблюдения после КШ, однако вместе с тем имеются публикации, говорящие о том, что в отдаленной перспективе (5–10 лет после проведенного вмешательства) процент выживших женщин выше, чем мужчин. Литературный обзор посвящен изучению отдаленных осложнений и выживаемости пациентов после КШ в зависимости от пола. На сегодняшний день большинство данных о половых различиях после КШ основаны на исследованиях с преобладанием мужчин, и из-за этого становится неясно, в какой степени полученные результаты справедливы для лиц женского пола. Большинство исследователей показывают, что у пациентов женского пола выше степень коморбидности, другим фактором риска является возраст – женщины попадают на операционный стол в более старшем возрасте. Помимо вышеперечисленных факторов на отдаленную выживаемость также влияют полнота реваскуляризации и мультиартериальное шунтирование. Текущая диагностика и алгоритмы лечения смещены в сторону оценки ишемической болезни сердца (ИБС) у мужчин, что потенциально может привести к неверной диагностике или интерпретации существующего заболевания и неправильно выбранной тактике лечения у лиц женского пола. Несмотря на большой объем накопленных знаний, данный вопрос продолжает оставаться открытым и требует проведения новых исследований и всестороннего изучения влияния фактора пола на отдаленную выживаемость.

The study of long-term results of coronary artery bypass grafting (CABG) in patients with different sexes has been a relevant problem of cardiology and heart surgery over the past thirty years. Female sex is an independent risk factors for worse outcomes in the long-term follow-up period after CABG according to many studies. However, there are publications suggesting that the results in women are better than in men in the long-term period after CABG. This literature review is devoted to studies of long-term complications and survival in patients after CABG depending on their gender. The evidence for gender differences after CABG is currently based on male-dominated studies. Most authors show that women have a higher degree of comorbidity. Another risk factor is age. Women undergo surgery at an older age. Besides, long-term survival is affected by the completeness of revascularization and multiarterial bypass grafting. Current diagnostic and treatment algorithms shift towards the assessment of coronary artery disease in men, which potentially may result in incorrect diagnosis or interpretation of existing disease and incorrect choice of treatment tactics in female patients. Despite large pool of accumulated data, this question remains open and requires new trials and continuing studies focusing on the impact of gender factor on the long-term survival.

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The authors declare that there are no conflicts of interest present.