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

• Main Authors: A. V. Svarovskaya, E. A. Kuzheleva, A. A. Arzhanik, V. A. Fediunina, V. A. Aleksandrenko, A. D. Starchenko, A. A. Garganeeva
• Format: Article
• Language: Russian
• Published: «FIRMA «SILICEA» LLC 2020-07-01
• Series: Российский кардиологический журнал
• Subjects: endothelin-1; coronary heart disease; myocardial revascularization; prognosis; insulin resistance; obesity
• Online Access: https://russjcardiol.elpub.ru/jour/article/view/3938

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.