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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">evrazkar</journal-id><journal-title-group><journal-title xml:lang="ru">Евразийский Кардиологический Журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Eurasian heart journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2225-1685</issn><issn pub-type="epub">2305-0748</issn><publisher><publisher-name>Евразийская ассоциация кардиологов</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.38109/2225-1685-2025-4-48-60</article-id><article-id custom-type="elpub" pub-id-type="custom">evrazkar-6557</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL PAPERS</subject></subj-group></article-categories><title-group><article-title>Сравнительная оценка отдаленных результатов чрескожного коронарного вмешательства и оптимальной медикаментозной терапии у пациентов с многососудистым поражением коронарного русла, нетолерантных к аортокоронарному шунтированию</article-title><trans-title-group xml:lang="en"><trans-title>Comparative evaluation of long-term results of percutaneous coronary intervention and optimal medical therapy in patients with multivessel coronary artery disease not eligible for coronary artery bypass graft</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3235-3364</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зайнобидинов</surname><given-names>Ш. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Zaynobidinov</surname><given-names>Sh. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зайнобидинов Шохбозбек Шаробидин угли, научный сотрудник, научно-исследовательский отдел эндоваскулярной хирургии, врач по рентген-эндоваскулярным диагностике и лечению</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p></bio><bio xml:lang="en"><p>Shokhbozbek Sh. Zaynobidinov, Surgeon, Department of Interventional Radiology Diagnostics and Treatment</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p></bio><email xlink:type="simple">shox.4454303@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4480-2585</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бадоян</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Badoyan</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бадоян Арам Газоевич, к.м.н., научный сотрудник, научно-исследовательский отдел эндоваскулярной хирургии, врач по рентгенэндоваскулярным диагностике и лечению</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p></bio><bio xml:lang="en"><p>Aram G. Badoyan, Cand. Of Sci. (Med.), Surgeon, Department of Interventional Radiology Diagnostics and Treatment</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p></bio><email xlink:type="simple">soir007@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5419-913X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хелимский</surname><given-names>Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Khelimskii</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хелимский Дмитрий Александрович, к.м.н., научный сотрудник, научно-исследовательский отдел эндоваскулярной хирургии, врач по рентгенэндоваскулярным диагностике и лечению</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p></bio><bio xml:lang="en"><p>Dmitrii A. Khelimskii, Cand. Sci. (Med.), Surgeon, Department of Interventional Radiology Diagnostics and Treatment</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p></bio><email xlink:type="simple">dkhelim@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2320-2233</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баранов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Baranov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баранов Алексей Алексеевич, аспирант</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p></bio><bio xml:lang="en"><p>Alexey A. Baranov, Graduate Student</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p></bio><email xlink:type="simple">ivrach@icloud.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7627-4890</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Махмудов</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Makhmudov</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Махмудов Мамуржон Али угли, аспирант</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p></bio><bio xml:lang="en"><p>Mamurjon A. Makhmudov, Graduate Student</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p></bio><email xlink:type="simple">makhmudov.mamur@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4882-4191</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Эралиев</surname><given-names>Т. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Eraliev</surname><given-names>T. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Эралиев Талант Каканович, доцент кафедры клинических дисциплин</p><p>ул. Ленина, д. 331, Г. Ош 723500</p></bio><bio xml:lang="en"><p>Talant K. Eraliev, Associate professor of the Department of clinical disciplines 3</p><p>331 Lenin St., Osh 723500</p></bio><email xlink:type="simple">smiling@inbox.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4010-7518</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цыденова</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsydenova</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Цыденова Арюна Юрьевна, научный сотрудник, научно-исследовательский отдел эндоваскулярной хирургии, врач по рентген-эндоваскулярным диагностике и лечению; ассистент кафедры сердечно-сосудистой хирургии (ФПК и ППВ)</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p><p>Красный проспект, д. 52, г. Новосибирск 630091</p></bio><bio xml:lang="en"><p>Aryuna Yu. Tsydenova, Surgeon, Department of Interventional Radiology Diagnostics and Treatment; assistant of the Department of cardiac surgery</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p><p>52 Krasny Prospekt, Novosibirsk 630091</p></bio><email xlink:type="simple">tsydenova_a@meshalkin.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1384-7185</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Найденов</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Naydenov</surname><given-names>R. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Найденов Роман Александрович, к.м.н., заведующий отделением рентгенохирургических методов диагностики и лечения, врач по рентген-эндоваскулярным диагностике и лечению</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p></bio><bio xml:lang="en"><p>Roman A. Naydenov, Cand. Of Sci. (Med.), Surgeon, Head of Department of Endovascular Diagnostics and Treatment</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p></bio><email xlink:type="simple">r_naydenov@meshalkin.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крестьянинов</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Krestyaninov</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Крестьянинов Олег Викторович, д.м.н., заведующий научно-исследовательским отделом эндоваскулярной хирургии, врач по рентген-эндоваскулярным диагностике и лечению</p><p>Ул. Речкуновская, д. 15, г. Новосибирск 630055</p><p>Красный проспект, д. 52, г. Новосибирск 630091</p></bio><bio xml:lang="en"><p>Oleg V. Krestyaninov, Dr. Of Sci. (Med.), Head of Center for Endovascular Surgery, Head of Department of Endovascular Diagnostics and Treatment; Professor of the Department of cardiac surgery</p><p>15 Rechkunovskaya St., Novosibirsk 630055</p><p>52 Krasny Prospekt, Novosibirsk 630091</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ им ак Е.Н. Мешалкина» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Meshalkin National Medical Research Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Ошский государственный университет</institution><country>Кыргызстан</country></aff><aff xml:lang="en"><institution>Osh State University</institution><country>Kyrgyzstan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ им ак Е.Н. Мешалкина» Минздрава России; ФГБОУ ВО Новосибирский государственный медицинский университет Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Meshalkin National Medical Research Center; Novosibirsk State Medical University (NSMU)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>26</day><month>11</month><year>2025</year></pub-date><volume>0</volume><issue>4</issue><fpage>48</fpage><lpage>60</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Зайнобидинов Ш.Ш., Бадоян А.Г., Хелимский Д.A., Баранов А.А., Махмудов М.А., Эралиев Т.К., Цыденова А.Ю., Найденов Р.А., Крестьянинов О.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Зайнобидинов Ш.Ш., Бадоян А.Г., Хелимский Д., Баранов А.А., Махмудов М.А., Эралиев Т.К., Цыденова А.Ю., Найденов Р.А., Крестьянинов О.В.</copyright-holder><copyright-holder xml:lang="en">Zaynobidinov S.S., Badoyan A.G., Khelimskii D.A., Baranov A.A., Makhmudov M.A., Eraliev T.K., Tsydenova A.Y., Naydenov R.A., Krestyaninov O.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.heartj.asia/jour/article/view/6557">https://www.heartj.asia/jour/article/view/6557</self-uri><abstract><sec><title>Цель</title><p>Цель. Оценить отдаленные результаты чрескожного коронарного вмешательства (ЧКВ) в сочетании с оптимальной медикаментозной терапией (ОМТ) и только ОМТ у пациентов со стабильной формой ишемической болезни сердца (ИБС) и многососудистым поражением коронарного русла, нетолерантных к аортокоронарному шунтированию (АКШ).</p></sec><sec><title>Материал и методы</title><p>Материал и методы. В данное ретроспективное исследование были включены 374 пациента со стабильной ИБС и многососудистым поражением коронарного русла и высокого хирургического риска, госпитализированные за период с 2013 по 2022 гг. Пациенты были разделены на 2 группы: 1-я группа консервативной терапии (только ОМТ) и 2-я группа инвазивной стратегии (ЧКВ+ОМТ). Первичной комбинированной конечной точкой исследования была частота серьезных неблагоприятных сердечно-сосудистых и цереброваскулярных событий (МАССЕ). С целью балансировки групп по исходным характеристикам проводился Propensity score matching (PSM).</p></sec><sec><title>Результаты</title><p>Результаты. Из 374 пациентов после псевдорандомизации (PSM) было отобрано 321 пациентов: 107 в первую группу и 214 во вторую группу. Медиана возраста исследуемых пациентов составила 69 [61; 76] лет в первой группе и 66 [60; 74] лет во второй группе (р=0,212). Медиана баллов по шкале SYNTAX score составила 32 [24; 40] против 30 [24; 37], соответственно (р=0,239). Анализ отдаленных результатов был проведен у пациентов 306 пациентов из 321 (95,3%). Частота первичной конечной точки (МАССЕ) в группе консервативной стратегии составила 64,1% против 51,8 в инвазивной, р=0,034.</p></sec><sec><title>Заключение</title><p>Заключение. Инвазивная стратегия (ЧКВ+ОМТ) у пациентов с ИБС и многососудистым поражением коронарного русла и нетолерантных к АКШ, сопровождается высокой частотой процедурного успеха и низкой частотой внутригоспитальных осложнений. Реваскуляризация миокарда методом ЧКВ у данной когорты пациентов приводит к статистически значимому снижению частоты развития МАССЕ и сердечной смертности в отдаленном периоде наблюдения в сравнении с консервативной терапией.</p></sec></abstract><trans-abstract xml:lang="en"><p>Aim. To evaluate the long-term results of percutaneous coronary intervention (PCI) plus optimal medical therapy (OMT) and OMT alone in patients with stable chronic coronary syndrome (CCS) and multivessel coronary artery disease who were not eligible for coronary artery bypass graft surgery (CABG).Material and methods. This retrospective study included 374 patients with stable CCS and multivessel coronary artery disease, not eligible for CABG, hospitalized between 2013 and 2022. Patients were divided into 2 groups: Group 1 conservative therapy (OMT alone) and Group 2 invasive strategy (PCI+OMT). The primary composite endpoint of the study was the incidence of major adverse cardiovascular and cerebrovascular events (MACCE). In order to balance the groups according to their initial characteristics, Propensity score matching (PSM) was performed.Results. Out of 374 patients, 321 patients were selected after PSM: 107 into the first group and 214 into the second group. The median age of the study patients was 69 [61; 76] years in group one and 66 [60; 74] years in group two (p=0,212). The median SYNTAX score was 32 [24; 40] versus 30 [24; 37], respectively (p=0,239). Long-term outcome analysis was performed in 306 patients out of 321 (95,3%). The incidence of the primary endpoint (MAСCE) in the conservative strategy group was 64,1% versus 51,8% in the invasive strategy group, p=0,034.Conclusion. Invasive strategy (PCI+OMT) in patients with CCS and multivessel coronary lesions and not eligible for CABG is accompanied by a high rate of procedural success and a low rate of in-hospital complications. Myocardial revascularization by PCI in this cohort of patients leads to statistically significant reduction in the incidence of MACCE and cardiac mortality in the long-term follow-up period in comparison with conservative therapy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ишемическая болезнь сердца</kwd><kwd>чрескожное коронарное вмешательство</kwd><kwd>оптимальная медикаментозная терапия</kwd><kwd>высокий риск</kwd><kwd>нетолерантность к аортокоронарному шунтированию</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ischemic heart disease</kwd><kwd>percutaneous coronary intervention</kwd><kwd>optimal medical therapy</kwd><kwd>high risk</kwd><kwd>not eligible for coronary bypass graft</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Formica F., Gallingani A., Tuttolomondo D. et al. 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