PROGNOSTIC VALUE OF CLINICAL, LABORATORY AND CARDIO IMAGING MARKERS OF PROGRESSION OF CORONARY ARTERY DISEASE

Abstract

The purpose is evaluation of the prognostic value of clinical, laboratory and cardiographic markers of the progression of coronary heart disease. Material and research methods. The objects of the clinical study were 152 patients with coronary artery disease (CAD), both genders, aged from 48 to 73 years. The main group included 73 patients with unstable angina pectoris (UAP). The comparison group consisted of 79 patients with stable angina pectoris (SAP) III FC. All patients with CAD underwent questionnaires (assessment of socio-anamnestic, behavioral, psychosocial indicators), clinical and functional status studies (ECG, EchoCG), biochemical (lipid spectrum, coagulogram), immunochemical (analysis of biomarkers of inflammatory response) indicators. In order to assess the cardio-visual aspects of the progression of coronary heart disease, an analysis of the value of the calcium index determined using multispiral computed tomography (MSCT) of the coronary arteries was carried out. Results. Based on the regression analysis, the most significant independent predictors of the destabilization of the CAD course were identified, in descending order by degree of significance, they turned out to be: combination of a high level of the Coronary calcium index according to CCTA and an increased concentration of IL-6/TNF-α in the blood (p=0.003), significantly increased Agatstone index (p=0.001), increased levels of IL-6 and/or TNF-α in the blood (p=0.015), combined anxiety-depressive states (p=0.036), dyslipidemia (p=0.001), Systolic blood pressure per 20 mm Hg (p=0.026), obesity (p=0.05), smoking (p=0.05), male sex (p=0.05) and age>60 (p=0.036). Conclusion. Thus, The results obtained prove the safety and high efficiency of the use of methods for predicting the risk of adverse cardiovascular events in patients with coronary heart disease, by quantifying a number of clinical and laboratory indicators, as well as cardioimaging markers according to Coronary computed tomography angiography (CCTA).