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LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 IN CARDIOVASCULAR RISK STRATIFICATION AFTER CORONARY ANGIOPLASTY IN PATIENTS WITH TYPE 2 DIABETES: WHICH DECISION RULE THRESHOLD TO CHOOSE?

By A. T. Teplyakov, A. V. Kuznetsova, N. V. Protopopova, A. V. Andriyanova, T. E. Suslova, O. N. Nasanova and V. V. Kalyuzhin

Abstract

<p>The research objective is to determine the posterior probability of adverse cardiovascular events after elective coronary intervention in patients with ischemic heart disease (IHD) associated with type 2 diabetes, at high level of lipoprotein-associated phospholipase A2 (Lp-PLA2) in blood serum, as well as to find out the optimal separation point value for this predictor, which increase allows to identify high risk with accuracy.<br />Material and methods. The 12-month cohort observational study included 60 patients (78% of men and 22% of women) with IHD associated with type 2 diabetes, aged 48–78. At the beginning of the study, along with conventional diagnostic techniques typical of a specialized cardiology clinic, the state of carbohydrate and lipid metabolism was analyzed and the proinflammatory status was evaluated (including assessment of Lp-PLA2 concentration by ELISA). At the end of the study distant results of treatment were assessed. The following events were taken into account: death of cardiovascular events, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization (surgical, endovascular) due to restricture formation of a primary implanted stent or stricture formation of native coronary arteries, angina pectoris relapses.<br />Results and discussion. The link between adverse cardiovascular events after elective percutaneous coronary intervention in patients with IHD type 2 diabetes-associated and high concentration of Lp-PLA2 in blood serum has been identified. Variation of the decision rule threshold on the performance curve has allowed to take Lp-PLA2 concentration of 983 ng/ml as a separation point. Accuracy of twoclass classification (determination of the posterior probability of adverse cardiovascular events) after identifying such separation point was characterized by 80% sensitivity and 100% specificity.<br />Conclusion. The increase in the Lp-PLA2 concentration in blood serum (&gt;983 ng/ml) may be considered as a predictor of adverse cardiovascular events after elective percutaneous coronary intervention in patients with IHD associated with type 2 diabetes.</p

Topics: ишемическая болезнь сердца, сахарный диабет 2-го типа, чрескожное коронарное вмешательство, воспаление, липопротеин-ассоциированная фосфолипаза А2, прогноз, Medicine, R
Publisher: Siberian State Medical University (Tomsk)
Year: 2015
OAI identifier: oai:doaj.org/article:ccfb94482bfc4a8abc5cc0ac9a01a07a
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