Predictors of adverse cardiovascular events in patients with coronary artery disease after percutaneous coronary intervention

Российский кардиологический журнал

A. V. Svarovskaya¹  E. A. Kuzheleva¹  V. A. Aleksandrenko²  A. A. Garganeeva²  V. A. Fediunina²  A. D. Starchenko³  A. A. Arzhanik⁴ 

[1] Cardiology Research Institute, Tomsk National Research Medical Centre;Cardiology Research Institute, Tomsk National Research Medical center;Regional Sol Center for Medical Rehabilitation;Saint Petersburg State University;

关键词: endothelin-1;    coronary heart disease;    myocardial revascularization;    prognosis;    insulin resistance;    obesity;   

DOI  :  10.15829/1560-4071-2020-3938

来源: DOAJ

【 摘 要 】

Aim. To identify predictors of major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).Material and methods. This prospective single-center study included 225 patients with stable CAD requiring drug-eluting stent implantation. The average follow-up period for patients was 14,5 (6;23) months. Levels of glycated hemoglobin (HbA1c), insulin, tumor necrosis factor (TNF)-α, interleukin-6 (IL-6), interleukin-10 (IL-10), endothelin-1 (ET-1) and the serum lipid profile were evaluated. Insulin resistance was assessed by the HOMA-IR index. The patients were divided into 2 groups: group 1 (n=98) — patients with MACE, group 2 (n=127) — patients without MACE over the follow-up period.Results. During the follow-up period, MACE were recorded in 43,5% of patients, of which: fatal outcome in 3 (3,1%) patients, acute coronary syndrome (ACS) — 14 (14,3%), decompensated heart failure (HF) — 8 (8,2%), non-fatal myocardial infarc tion (MI) — 4 (4,1%), stroke — 3 (3,1%), in-stent restenosis — 18 (18,4%), target vessel revascularization due to progression of atherosclerosis — 25 (25,4%), lifethreatening arrhythmias — 18 (18,4%), implantation of a cardiac resynchronization therapy defibrillator — 5 (5%). To determine critical levels for quantitative predictors, ROC curves were created with threshold values that increase the likelihood of MACE.Conclusion. As a result of the study, we found that the waist-to-hip ratio >1,0495, the HOMA-IR index >3,13 and the endothelin-1 >0,75 mmol/L are independent predictors of unfavorable prognosis in patients with CAD after PCI.

【 授权许可】

Unknown