Подъем маркеров некроза миокарда у больных с хронической ишемической болезнью сердца и артериальной гипертензией и однолетний прогноз

Abstract

Aim. The aim of our study was to assess the prevalence of myocardial infarction (MI) type 4a and myocardial damage due to planned percutaneous interventions (PCI) in patients with stable coronary artery disease (CAD) and arterial hypertension (AH).Material and methods. 281 patients were screened before the enrollment in our study. 183 patients with stable CAD were included in our study whose levels of cardiac troponin I and CK-MB (creatine kinase-MB fraction) were studied after PCI. We divided patients into the groups according to their levels of cardiac troponin I after PCI and CK-MB (group 1 - no elevation; 2 - elevation 1-3 upper limits of normal - ULN; III - more than 3 ULN).167 patients had AH. In case of detected rise of CK-MB and/or troponin echocardiography and cardiac magnetic resonance imaging (MRI) were performed. Results. The prevalence of MI type 4a was 10,8% and periprocedural myocardial damage - 16,2% respectively. After performing the discriminant analysis we sought to build a prognostic model and calculate the formula of periprocedural myocardial damage probability: 0,871 × gender (male = 0; female = 1)+0,516 × angina pectoris functional class + 0,022 × age (years) - 0,011 × (estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease - MDRD formula) + 0,27 × number of diseased coronary arteries ≥2,731.Conclusion. Women with low EGFR (MDRD), mutivessel disease and angina pectoris class 3-4 (NYHA) have the highest risk of MI type 4a. The most difficult localization for PCI is circumflex artery.