Role of endothelial dysfunction and metabolic syndrome in interventional treatment complications development in patients with coronary heart disease

Abstract

Aim. To assess the influence of endothelial dysfunction and metabolic syndrome on interventional treatment coronary complications development in patients with coronary heart disease. Methods. 57 patients with coronary heart disease and concomitant metabolic syndrome (the main group) and 64 patients with coronary heart disease alone (the comparison group) were included in the study. Control group for endothelial function parameters included 33 healthy blood donors. Endothelial function was assessed by plasma and erythrocyte nitrate level, plasma L-arginine level and desquamated endothelial cell blood count before the interventional treatment and after its completion. Results. Initial signs of endothelial dysfunction were observed in both groups of patients compared to the controls. Desquamated endothelial cell blood count was significantly higher in patients with metabolic syndrome than in the comparison group. Only the desquamated endothelial cell blood count increased significantly after the interventional treatment, the difference was more pronounced (р 0.05) in patients with metabolic syndrome. Complications of interventional treatment in patients with and without symptoms of metabolic syndrome were observed in 29.8 and 14.1% respectively (р 0.05). The number of coronary artery restenoses was significantly higher in the main group than in the comparison group (12.2 and 3.1% respectively). Conclusion. Initially endothelial dysfunction was more pronounced in patients with metabolic syndrome. A significant increase of endothelial dysfunction was observed in patients of the main group after the interventional treatment. The number of interventional treatment complications and coronary arteries restenoses was significantly higher in patients with coronary heart disease and concomitant metabolic syndrome.