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

• Published in: Rossiĭskiĭ kardiologicheskiĭ zhurnal Vol. 25; no. 6; p. 3938
• Main Authors: Svarovskaya, A. V., Kuzheleva, E. A., Arzhanik, A. A., Fediunina, V. A., Aleksandrenko, V. A., Starchenko, A. D., Garganeeva, A. A.
• Format: Journal Article
• Language: English; Russian
• Published: FIRMA «SILICEA» LLC 11.07.2020
• Subjects: coronary heart disease; endothelin-1; insulin resistance; myocardial revascularization; obesity; prognosis
• ISSN: 1560-4071; 2618-7620
• DOI: 10.15829/1560-4071-2020-3938

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.