Levels of proprotein convertase subtilisin/kexin type 9 in patients with acute myocardial infarction

Aim. To study the levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) in patients with acute myocardial infarction (MI).Material and methods. The study included 74 patients with acute MI. PCSK9 was determined by enzyme-linked immunosorbent assay.Results. The mean PCSK9 levels were 479,7±15,4 ng/ml. No significant correlation was found between PCSK9 and total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides. In the group of smokers, a significant inverse correlation was found between the levels of PCSK9 and HDL-C (-0,45; p=0,039). In the group of patients with body mass index <25 kg/m2, a significant inverse correlation of PCSK9 levels with total cholesterol (-0,45, p=0,008), HDL-C (-0,42; p=0,029) and LDL-C (-0,47; p=0,003) was found.Conclusion. In patients with MI, a correlation of PCSK9 levels with lipid profile was found in smokers, as well as in patients with a low body mass index

The predictive value of preprocedural laboratory data in patients with coronary artery restenosis in various types of stents

Aim. To identify the effect of preprocedural laboratory parameters on the occurrence of in-stent restenosis in various types of stents, to assess the significance of gender, age and various forms of coronary artery disease (CAD) as risk factors for coronary artery restenosis after stenting.Material and methods. The study included 436 patients with CAD, which were divided into 2 groups. The study group included 218 patients with in-stent restenosis. The control group consisted of 218 patients with CAD without in-stent restenosis. Inclusion criteria were acute or chronic form of CAD, age 45-74 years, CAG and percutaneous coronary intervention (PCI) with emergency or planned stenting of the native coronary artery, repeated CAG in history due to signs/symptoms of myocardial ischemia. Exclusion criteria: age younger than 45 years and over 74 years, coronary artery bypass surgery (CABG), cancer, autoimmune disease, anemia, liver failure, chronic kidney disease S4-S5, recent blood transfusion, hypo-or hyperthyroidism.Results. According to the study, the risk in-stent restenosis is 5,2 times higher in patients in the 65-69 years age group and 9,9 times higher in the 70-74 years age group compared with the group of young patients (45-49 years). In-stent restenosis is 2,7 times more common in men than in women. Predictors of restenosis were red cell distribution width, mean platelet volume, Gensini score with OR 1,5; 1,4; 1,1; 1,5, respectively.Conclusion. Risk factors for coronary artery restenosis after stenting are markers of chronic inflammation, such as the red cell distribution width, mean platelet volume. The risk of restenosis is higher in the male population. In old age, the risk of restenosis increases, however, young people and middle-aged people do not differ in risk of in-stent restenosis

Risk factors of coronary artery disease in 27425 outpatients

Aim. To identify risk factors in outpatients without signs of coronary artery disease (CAD).Material and methods. The Portavita computer program adapted to Russian conditions was used. Information was collected and entered into the module by district doctors and general practitioners during outpatient visits. The program involved 9 clinics, 406 district doctors and general practitioners. Individual data on sex, age, family history of CAD, smoking, physical activity, blood pressure, cholesterol level, creatinine (with the calculation of the glomerular filtration rate) and blood plasma glucose were made. Next, the system determined the risk of death from CAD according to the SCORE scale. In total, the data were entered by 27425 citizens aged 18 to 80 years old who have no obvious signs of CAD. Based on the data obtained, the program selected individual preventive measures for each patient. Then, on the basis of the initial data, the date of the next examination of each patient was planned. Results. In the group of people without CAD (27425 people blood pressure of more than 140/90 mm Hg was detected in 66,2% of patients, body mass index more than 30 kg/m2 — in 23% of patients, the level of total blood plasma cholesterol more than 5,2 mmol/l — in 68% of patients (including more than 8 mmol/l — in 874 people), plasma glucose levels of more than 6,1 mmol/l — in 13% of patients. On the SCORE  risk scale, data were calculated for 22907 people, while more than 10 points were found in 7% of the subjects.Conclusion. In ambulatory patients with no signs of CAD, arterial hypertension (66,2%) and total blood plasma cholesterol of more than 5,2 mmol/l (68%) are the most frequently recorded risk factors. The combination of two risk factors (arterial hypertension + total blood plasma cholesterol more than 5,2 mmol/l) is recorded regardless of age (younger than 60 years and older than 60 years) — in cases of 61,8% and 64,2%, respectively

Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in Europe: The ACVC-EAPCI EORP STEMI Registry of the European Society of Cardiology

Aims: The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results: Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0-100%), fibrinolysis (18.8%; 0-100%), and no reperfusion therapy (9.0%; 0-75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5-5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8-97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1-70.1%) for timely reperfusion. Conclusions: The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality