Abstract
Objective: To identify the independent laboratory predictors of the risk of recurrent cardiovascular events in patients with unstable angina and arterial hypertension for the first year follow-up. Design and method: We studied 126 patients (pts) with unstable angina (UA). In the 1st group included 48 pts (38%) without concomitant arterial hypertension (AH), mean age 59.2 + −7.7 years. In group 2 included 78 pts (62%) with unstable angina in combination with hypertension, average age was 57.4 + −6.4 years. All pts underwent a complete blood count, determination of cardiac enzymes (troponin I, CKMB, biochemical blood tests, a marker of inflammation CRP, levels of myeloperoxidase (MPO), von Willebrand factor (VWFr), thrombin level, determining the activity of platelets, D-dimers (DD), Xa factor, aggregatogram with analyzer Multiplate and determination of platelet activation by flow cytometry, determining the activity of platelets, brain natriuretic peptid (BNP), ECG, EchoCG, Holter ECG, ABPM, coronary angiography. Results: 24 months follow-up, four pts developed Q myocardial infarction: 2 pts of group 1 (4.2%) and in 2 pts in group 2 (2.6%). Four pts from group 1 and five pts from group 2 performed coronary artery bypass grafting for urgent indications. 37 pts underwent coronary stenting due to the development of recurrent angina: 10 pts (20.8%) of one group (UA without AH) and 27 pts (34.6%) of the 2 groups (UA in combination with AH). Independent laboratory predictors of the risk of recurrent cardiovascular events (acute heart failure, myocardial infarction, death) after unstable angina patients with hypertension are: baseline VWFr above 143% (sensitivity −75.6%, specificity −94.6%), level of MPO above 330 pmol / L (sensitivity −80,0%, specificity - 91.0%), platelet volume MPV more than 9.7 fl (sensiivity - 86,0%, specificity - 96%). Independent laboratory predictors of adverse outcomes in pts with UA without of AH are: baseline level of CRP above 6.6 g/L (sensitivity −80.4%, specificity −89.5%) and BNP more than 111 pg/ml (sensitivity −83.0%, specificity −96%). Conclusions: Independent predictors of adverse outcomes in pts with UA and AH are baseline level of VWFr, MPO, MPV; in pts without AH- CRP and BNP.
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