[Quality of life of patients after coronary bypass surgery: effect of age and personality type D].

AIM: To study effect of age and presence of personality type D on quality of life (QL) of patients in one year after coronary bypass surgery (CBS). MATERIAL AND METHODS: Assessment of QL before and after surgery was carried out in 408 patients. Two groups were formed: patients younger than 60 years (n=233) and older than 60 years (n=175). Quality of life and presence of personality type D was assessed by questionnaires SF-36 and DS-14, respectively. RESULTS: In a year after CBS improvement of physical and psychological components of QL (p<0.05) was noted in both groups. Personality type D was more frequent among patients older than 60 years (p<0.01). Patients with personality type D had worse parameters of irrespective of age (p<0.01). Personality type D correlated directly with age QL (p=0.003) and inversely with parameters of QL (p<0.01). Presence of personality type D was an independent predictor of low level of physical (together with index of atherogenecity prior to surgery) and psychological components of QL at multiple logistic regression analysis. CONCLUSION: Assessment of personality traits of patients before CBS can be helpful for targeted measures aimed at improvement of QL what is especially important for older age groups.

[Factors influencing life quality improvement in patients of different age one year after coronary artery bypass surgery].

The study was aimed at examining the factors having an impact on changes in the quality of life (QL) parameters a year after coronary artery bypass surgery (CABG) in different age groups. 408 patients aged 31-79 years had their QL assessed by means of the SF-36 questionnaire before and one year after elective CABG. Additionally, the patients were tested for the presence of type D personality before and one year after CABG by means of the DS-14 questionnaire. The groups were comparable in terms of previous carotid endarterectomy, peripheral arterial and aortic reconstruction number (p > 0.05). One year after CABG the improved QL (p < 0.01) was reported whereas type D patients had significantly poorer psychological test results (p < 0.01). One year after CABG type D personality and high Euroscore had an independent impact on the QL improvement while previous carotid endartectomies resulted in a significantly improved psychological health component. Thus, along with the detection and treatment of non-coronary lesions the personality type assessment and focused behavioral interventions can contribute to the QL improvement in long-term CABG period.

[Prevalence of multifocal atherosclerosis in different age groups].

Aim of the study was to assess prevalence of lesions in several arterial beds in patients with atherosclerosis of various localization in the clinic of cardiovascular surgery. We examined 1018 patients (825 men and 193 women, aged 31-78 years, mean age 59+/-12 years) in the period of preparation to elective surgical interventions on coronary arteries or other arterial beds. All patients were divided into 4 age groups: group 1 - younger than 60 years (n=542), group 2 - 60-64 years (n=215), group 3 - 65-69 years (n=141), group 4-70 years and older (n=120). All patients were subjected to coronary angiography and Doppler ultrasound investigation (USI) of extracranial arteries. USI of arteries of lower extremities and angiography of peripheral arteries were carried out if indicated. Presence of 50% or greater stenosis was considered a criterion of involvement of an arterial vascular bed. Lesions in 2 or more beds were found in 321 patients (31.5%). Stenoses in 2 and 3 arterial beds were revealed in 24 and 3.5%, respectively, of patients in group 1, and in 31.8 and 10%, respectively, of patients in group 4 (p=0.008). Purposeful diagnostics of multifocal atherosclerosis in patients of the given category apparently should not be limited by older age groups.

[Quality of life in patients of different age groups with ischemic heart disease: effect of multifocal atherosclerosis].

The aim of the research was to study the quality of life for the patients of different age groups with coronary artery disease and to evaluate the factors affecting its decline. The present study included 709 patients aged 31 to 79 years examined before elective coronary artery bypass graft surgery. All patients underwent coronary angiography, echocardiography, ultrasonography of the aorta, brachiocephalic, and peripheral arteries. With age, significantly increased incidence of multifocal atherosclerosis (p = 0.01 for the trend). To study the quality of life (QL) a non-specific questionnaire SF-36 was used, according to which the reduction of QL equally in all the groups (p > 0.05) was detected. Multivariate analysis showed that the level of QL was influenced by diabetes, myocardial infarction and the presence of multifocal atherosclerosis (p < 0.05). Thus, in order to improve the QL in aged patients with multifocal atherosclerosis is reasonable to conduct of reconstructive operations at different arterial basins.