Chronic Coronary Artery Occlusion Research Articles

Recanalization of Chronic Total Occlusions Using Modern Endovascular Techniques

to assess results of percutaneous coronary intervention (PCI) with contemporary endovascular techniques of recanalization of chronic total coronary artery occlusions (CTO) in patients with ischemic heart disease (IHD). Occlusion (CTO) he procedural and in-hospital outcomes of consecutive patients undergoing chronic total occlusion percutaneous coronary intervention. We retrospectively analyzed data from 456 consecutive patients (mean age 59.9±7.1 years, 18.2 % women) who underwent CTO PCI procedures (n=477) during 2014-2016 in the E. N. Meshalkin National Medical Research Center. CTO was localized in the right (61.2 %), left anterior descending (23.2 %) and left circumflex (15.3 %) coronary arteries. In one patient CTO was located in the left main coronary artery. According to the J-CTO score, 30 % of lesions were classified as easy, 36.4 % intermediate, 23.7 % difficult, and 18.9 % very difficult. Technical and procedural successes were achieved in 374 (78.4 %) and 366 patients (76.7 %), respectively. Antegrade approach was used in 378 (79.2 %), retrograde approach - in 99 (20.7 %) cases. Retrograde approach as primary strategy was used in 27 cases (5.7 %). Most frequent access for CTO PCI was radial artery, contralateral injection was used in 151 cases (31.6 %). Total number of stents per lesion was 1.6±0.98. The mean fluoroscopy time was 36.2±31 min. The rate of procedural adverse events in our study was low and similar to the non-CTO PCI series. However, despite the large number of CTO PCIs, the procedural success rate was still lower than in centers with dedicated programs for the management of such patients. Thus, further work is required to overcome this difference. Possible solution of this problem might be development and introduction in clinical practice of an algorithm for CTO recanalization.

Risk factors for complications during recanalization of chronic coronary artery occlusions in patients with coronary artery disease

The aim — to analyze the risk factors for periprocedural complications during recanalization of chronic coronary artery (CA) occlusions in patients with coronary artery disease.Materials and methods. The study included 365 patients with chronic of CA occlusions, which, on the basis of X‑ray angiography department of M. M. Amosov National Institute of Cardiovascular Surgery of National Academy of Medical Sciences of Ukraine underwent diagnostic and therapeutic intervention procedures for this pathology. The patients’ age was from 62 to 73 years old (average age — 66.96 ± 1.81 years). Occlusions were localized mainly in the proximal (167 (45.8 %) cases) and middle (198 (54.2 %) CA segments. The duration of occlusion was determined from the time of myocardial infarction in the infarct‑related CA pool. Occlusion duration from 3 to 6 months was recorded in 98 (26.8 %) patients, from 6 to 12 months — in 137 (37.5 %) patients, from 1 to 3 years — in 130 (35.6 %) patients. Chronic occlusion of one CA was detected in 93 (25.5 %) persons, two CA — in 127 (34.79 %) persons, three CA — in 56 (15.3 %) persons. In 89 (24.38 %) patients, multiple atherosclerotic lesions of the coronary bed were diagnosed. Mean number of affected CA in one patient was 2.17 ± 0.34.Results and discussion. Out of 235 patients with the term of occlusion up to 1 year, a good angiographic result was achieved in 87.2 %, out of 130 persons with occlusion duration of 1— 3 years — in 72.3 %. The average number of implanted stents was 2.12 ± 0.3 per one patient. 51 (13.97 %) patients had periprocedural complications. The development of «big» complications of X‑ray endovascular coronary interventions for chronic occlusion of CA was statistically significantly influenced by the patient’s age and smoking (p < 0.05), the probability of developing «small» periprocedural complications — by body mass index and diabetes.Conclusions. Risk factors for the development of «big» complications are femoral access, the duration of the procedure and fluoroscopy, the amount of contrast material used during the procedure.

Quality and Safety in Health Care, Part XL: Stents and Unusual Indications for a PCI.

Percutaneous coronary interventions (PCI) are done for a variety of indications. Data from the CathPCI Registry is highly useful to evaluate the outcomes from performing a PCI procedure in unusual circumstances, such as in cases of chronic total coronary artery occlusion, cardiogenic shock after a myocardial infarction, syncopal patients, asymptomatic patients, and before surgery that is noncardiac. Registry information is also valuable in evaluating the efficacy of coronary stents. This article summarizes some of the information available on these subjects.

OP-475 - Chronic Total Coronary Artery Occlusions: Prevalence, Mortality and Morbidity Post Cabg and its Prognosis

OP-475 - Chronic Total Coronary Artery Occlusions: Prevalence, Mortality and Morbidity Post Cabg and its Prognosis

Pleiotrophin levels are associated with improved coronary collateral circulation

Elucidation of the underlying mechanisms of angiogenesis and arteriogenesis in coronary collateral formation is necessary for new therapies. Pleiotrophin is a secreted multifunctional cytokine and associated with the formation of functional cardiovascular neovascularization in a series of experimental animal models. We aimed to evaluate the serum levels of pleiotrophin in patients with chronic total coronary artery occlusion and poor or good collateral development. We included 88 consecutive patients (mean age of the entire population: 63.7±12.1 years, 68 male patients) with stable angina pectoris who underwent coronary angiography and had chronic total occlusion in at least one major coronary artery. Collateral grading was performed according to the Rentrop classification. After grading, patients were divided into poor collateral circulation (Rentrop grade 0 and 1) and good collateral circulation (Rentrop grades 2 and 3) groups. Serum pleiotrophin levels were measured using a commercial human ELISA kit. Fifty-eight patients had good and 30 patients had poor coronary collaterals. The good collateral group had higher serum pleiotrophin levels than the poor collateral group (690.1±187.9 vs. 415.3±165.9 ng/ml, P<0.001). Pleiotrophin levels were higher with higher Rentrop grade (P<0.001). In multivariate analysis, increased pleiotrophin was associated independently with good collateral development (odds ratio: 1.007; confidence interval: 1.003-1.012; P=0.002). This study showed that increased serum pleiotrophin levels are associated with better developed coronary collateral circulation. Further studies are needed to better understand the relationship.

Predictors of Successful Hybrid-Approach Chronic Total Coronary Artery Occlusion Stenting: An Improved Model With Novel Correlates

ObjectivesThe aim of this study was to develop a hybrid approach–specific model to predict chronic total coronary artery occlusion (CTO) percutaneous coronary intervention success, useful for experienced but not ultra-high-volume operators. BackgroundCTO percutaneous coronary intervention success rates vary widely and have improved with the “hybrid approach,” but current predictive models for success have major limitations. MethodsData were obtained from consecutively attempted patients from 7 clinical sites (9 operators, mean annual CTO volume 61 ± 17 cases). Angiographic analysis of 21 lesion variables was performed centrally. Statistical modeling was performed on a randomly designated training group and tested in a separate validation cohort. The primary outcome of interest was technical success. ResultsA total of 436 patients (456 lesions) met entry criteria. Twenty-five percent of lesions had prior failed percutaneous coronary interventions at the site. The right coronary artery was the most common location (56.4%), and mean occlusion length was 24 ± 20 mm. The initial approach was most often antegrade wire escalation (70%), followed by retrograde (22%). Success was achieved in 79.4%. Failure was most closely correlated with presence of an ambiguous proximal cap, and in the presence of an ambiguous proximal cap, specifically defined collateral score (combination of Werner and tortuosity scores) and retrograde tortuosity. Without an ambiguous proximal cap, poor distal target, occlusion length >10 mm, ostial location, and 1 operator variable contributed. Prior failure, and Werner and tortuosity scores alone, were only weakly correlated with outcomes. The basic 7-item model predicted success, with C statistics of 0.753 in the training cohort and 0.738 in the validation cohort, the later superior (p < 0.05) to that of the J-CTO (Multicenter CTO Registry of Japan) (0.55) and PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) (0.61) scores. ConclusionsSuccess can be reasonably well predicted, but that prediction requires modification and combination of angiographic variables. Differences in operator skill sets may make it challenging to create a powerful, generalizable, predictive tool.

TCT-417 Bioresorbable vascular scaffold in chronic total coronary artery occlusions: results from the RAI registry

Bioresorbable vascular scaffold (BVS) implantation appears to be a potentially beneficial therapeutic option in chronic total coronary artery occlusions (CTO). The available data on BVS use in this challenging subset of lesions is limited. RAI registry (Registry Absorb Italian, [ClinicalTrials.gov

TCT-280 Does the effectiveness of recanalization of chronic total coronary occlusion depend on the location of obstruction?

Aim: Reports concerning the efficacy of recanalization of chronic coronary artery occlusion (CTO) depending on occlusion site are inconsistent. Some of them indicates a lower effectiveness of recanalization of the circumflex artery (Cx). Between January 2011 and January 2016, 357 PCI of CTO

A Food and Drug Administration-Approved Antiviral Agent that Inhibits Adenylyl Cyclase Type 5 Protects the Ischemic Heart Even When Administered after Reperfusion.

A Food and Drug Administration-approved antiviral agent, known as vidarabine or adenine 9-β-D-arabinofuranoside (AraA), has features of inhibiting adenylyl cyclase type 5 (AC5) and protects against chronic coronary artery occlusion (CAO). The goal of this investigation was to determine whether AraA protects against myocardial ischemia, even when delivered after coronary artery reperfusion (CAR). AraA, delivered after CAR in wild-type mice, reduced infarct size by 55% compared with vehicle-treated controls, whereas an equal dose of adenosine reduced infarct size only when administered before CAR. A 5-fold greater dose of adenosine was required to reduce infarct size when delivered after CAR, which also reduced arterial pressure by 15%, whereas AraA did not affect pressure. The reduction in infarct size with AraA was prevented by a MEK/extracellular signal-regulated kinase blocker, a pathway also involved in the mechanism of protection of the AC5 knockout (KO) model. Infarct size was also reduced in cardiac-specific AC5 KO mice similarly in the presence and absence of AraA, further suggesting that AraA protection involves the AC5 pathway. AraA reduced infarct size in chronically instrumented conscious pigs when delivered after CAR, and in this model, it also reduced post-CAR coronary hyperemia, which could be another mechanism for cardioprotection (i.e., by reducing oxidative stress during CAR). Thus, AraA inhibits AC5 and exhibits unique cardioprotection when delivered after CAR, which is critical for clinical translation.

ANALYSIS OF SURVIVAL AND CHANGES IN CLINICAL STATUS OF PATIENTS WITH CORONARY ARTERY DISEASE AFTER ENDOVASCULAR RECANALIZATION OF CHRONIC OCCLUSION OF THE RIGHT CORONARY ARTERY

Background: Procedures performed in chronic coronary artery occlusion comprise from 10 to 20% of all transcutaneous coronary interventions, and their efficacy can amount to 90%. Despite this, their appropriateness for this type of disease is still a matter of debate. Aim: To assess efficacy and safety of interventions compared to medical treatment in patients with isolated chronic occlusion of the right coronary artery. Materials and methods: We analyzed results of treatment of 72 patients. From these, endovascular recanalization of chronic occlusion of the right coronary artery was performed in 39 patients (group 1), the rest 33 patients received medical treatment only (group 2). Clinical state parameters and adverse event rate were assessed during a follow-up of 12 months. Results: After 1 year, a notable reduction of functional grade (FG) of exertional angina was seen in the group 1. The number of patients with FG I increased from 3 (7.7%) to 20 (51.3%), р 0.05 at both time points). At 1 year, 94.9% (95% CI: 88,2–99,9%) of patients from the group 1 and 100% of patient in the group 2 were free of adverse clinical events. Conclusion: Transcutaneous coronary angioplasty for chronic occlusion of the right coronary artery significantly improves clinical course of ischemic heart disease at 2 and 12 months, compared to medical treatment, by decreasing FG of exertional angina. From clinical point of view, adverse events reported in the group of endovascular recanalization for chronic occlusion of the right coronary artery are insignificant.

Overexpression of Cardiomyocyte α1A-Adrenergic Receptors Attenuates Postinfarct Remodeling by Inducing Angiogenesis Through Heterocellular Signaling.

Stimulation of cardiac α1A-adrenergic receptors (α1A-AR) has been proposed for treatment of heart failure, since it increases myocardial contractility. We investigated a different mechanism, induction of angiogenesis. Four to 6 weeks after permanent coronary artery occlusion, transgenic rats with cardiomyocyte-specific α1A-adrenergic receptor overexpression had less remodeling than their nontransgenic littermates, with less fibrosis, hypertrophy and lung weight, and preserved left ventricular ejection fraction and wall stress (all P<0.05). Coronary blood flow, measured with microspheres, increased in the infarct zone in transgenic rats compared with nontransgenic littermates (1.4±0.2 versus 0.5±0.08 mL min(-1) g(-1); P<0.05), which is consistent with angiogenesis, as reflected by a 20% increase in capillary density in the zone adjacent to the infarct. The question arose, how does transgenic overexpression of a gene in cardiomyocytes induce angiogenesis? We identified a paracrine mechanism, whereby vascular endothelial growth factor-A mRNA and protein were increased in isolated transgenic cardiomyocytes and also by nontransgenic littermate cardiomyocytes treated with an α1A-agonist, resulting in angiogenesis. Conditioned medium from cultured cardiomyocytes treated with an α1A agonist enhanced human umbilical vein endothelial cell tubule formation, which was blocked by an anti-vascular endothelial growth factor-A antibody. Moreover, improved cardiac function, blood flow, and increased capillary density after chronic coronary artery occlusion in transgenic rats were blocked by either a mitogen ERK kinase (MEK) or a vascular endothelial growth factor-A inhibitor. Cardiomyocyte-specific overexpression of the α1A-adrenergic receptors resulted in enhanced MEK-dependent cardiomyocyte vascular endothelial growth factor-A expression, which stimulates angiogenesis via a paracrine mechanism involving heterocellular cardiomyocyte/endothelial cell signaling, protecting against remodeling and heart failure after chronic coronary artery occlusion.

CT features in the early and late stages of chronic total coronary occlusions

ObjectivesTo investigate the morphologic characteristics of early and late stages of chronic total coronary artery occlusions (CTO) in coronary computed tomography angiography (coronary CTA). MethodsWe retrospectively analyzed patients who underwent coronary CTA and invasive coronary angiography and had at least one CTO with known duration. The following parameters were obtained in coronary CTA: calcification of the occluded segment; stump morphology; lesion length; remodeling index; presence of intra-occlusion linear contrast enhancement; and density of non-calcified CTO components. CT parameters were compared between patients with early (duration ≤ 12 months) and late (duration > 12 months) stage CTO. ResultsOne-hundred and twelve patients with 124 chronically occluded coronary arteries were analyzed. Fifty nine patients had early stage CTOs (62 lesions) and 53 patients had late stage CTOs (62 lesions). Calcification was more severe in late-stage versus early CTOs (Agatston score: early stage, 27.4 ± 46.7 vs. late stage, 58.3 ± 112.4; p = 0.049). Remodeling index was lower in late-stage CTOs (early stage, 0.96 ± 0.2 vs. late stage, 0.88 ± 0.22; p = 0.034). In patients with late stage CTO, the presence of intra-occlusion linear enhancement was more likely (45.2% vs 14.5%, p < 0.001), and the density of non-calcified components was significantly higher (85.4 ± 27.2 HU vs. 65.7 ± 30.1 HU, p < 0.001). Stump morphology was not different between the two groups. ConclusionsCoronary CTA reveals differences between chronic total coronary occlusions of longer and shorter duration. A long duration is associated with focal calcification and negative remodeling, as well as intra-occlusion enhancement and a higher density of non-calcified components.

What do Polish interventional cardiologists know about indications and qualification for recanalisation of chronic total coronary artery occlusions?

Chronic total occlusions (CTO) are diagnosed in about 20% of patients with significant coronary artery disease. A disproportion between the high prevalence of CTOs and low rate of invasive treatment still exists. Technical difficulties, clinical uncertainties whether patients benefit from recanalisation, and a lack of knowledge of CTO may be responsible for this fact. To assess the knowledge of coronary arteries CTO among Polish interventional cardiologists. A self-designed questionnaire was used during two major Polish invasive cardiology workshops held in 2014. The study included 113 physicians, mostly cardiologists certified as independent operators. Average self-declared efficacy of CTO recanalisation was 63.5%. Most of the respondents agreed that the operator involved in the CTO recanalisation program should perform at least 30-50 procedures per year. Only 67% stated that before CTO revascularisation the evaluation of myocardial viability should be performed with dobutamine stress echocardiography as a preferred test. One third of the physicians agreed that CTO percutaneous coronary intervention (PCI) should not be performed directly after diagnostic angiography, and 51.5% believed that in patients with multi-vessel coronary artery disease PCI of CTO should be performed first. Multi-slice spiral computed tomography during the qualification and planning of the CTO revascularisation, in the opinion of 91% of the responders, should not be used before each procedure but could be useful in selected cases. Polish interventional cardiologists remains in compliance with current opinions about recanalisation of chronic coronary artery occlusions and the consensus of the EuroCTO Club, but there is still an unceasing need for further education and promotion of knowledge about CTOs.

CLINICAL EVALUATION OF THE RESULTS OF DELAYED STENTING OF THE OCCLUDED CORONARY ARTERY

The aim is to evaluate the possibility of optimizing the conditions for stent implantation due to remodeling of the occluded coronary artery under the influence of hemodynamic factors of restored antegrade flow. Materials and methods. Recanalization and stenting of chronic coronary artery occlusion were performed in two stages (Group 1) or simultaneously (Group 2). Group 1 consisted of 36 patients, Group 2 – 50 patients. Time interval between the intervention stages in Group 1 was on an average 68 days (from 18 to 176 days). Groups did not differ by age, sex or clinical status of the patients. Repeated surveys were carried out in the following terms: 1 month, 6 and 12, 24 and 36 months after PCI. Results. At recanalization stage in Group 1, the difference of artery diameters at the proximal and distal ends of the occlusion zone exceeded the diameter of the distal segment and was 1.78 mm. In Group 2, the value was 0.53 ± 0.7 mm. At the second stage in Group 1, the difference of diameters of the proximal and distal segments decreased to 0.45 ± 0.26 mm by reducing the proximal and increasing the distal sizes of the artery. Remodeling of the coronary artery in Group 1 allowed performing adequate stent implantation at the second stage of intervention (in two months) in 34 cases. Two patients developed recanalized artery reocclusion in 43 and 176 days after the first stage. The clinical effect of recanalization of coronary arteries in both groups did not differ. Manifestations of angina decreased in both groups. According to the 36-month follow-up period not even one case of target lesion intervention was registered in both groups. Conclusion: Remodeling of coronary artery under the influence of blood flow factors observed within several weeks after recanalization, creates favorable conditions for the stent implantation. The method of delayed stenting for complicated forms of chronic occlusions when determining post-recanalization obliteration of the distal coronary bed is safe and acceptable since it allows obtaining an optimal clinical outcome.

Ventricular Tachycardic Storm with a Chronic Total Coronary Artery Occlusion Treated with Percutaneous Coronary Intervention

A 66-year-old man with a history of coronary artery disease was evaluated due to ventricular tachycardic (VT) storm. The patient continued to have frequent recurrences of VT despite treatment with amiodarone and lidocaine. Since the ventricular arrhythmia could be related to myocardial ischemia related to a chronic total occlusion (CTO) of the right coronary artery, the patient underwent successful percutaneous coronary intervention of the CTO, followed by implantable cardioverter defibrillator implantation. He had no further episodes of VT during his hospital stay. After 9 months of follow-up, he had no further chest pain or clinically apparent recurrent ischemia. Interrogation of his defibrillator has shown brief nonsustained episodes of ventricular tachycardia, but the patient has not required delivery of a shock. The temporal association between treatment of the CTO and resolution of the VT, as well as the lack of recurrence of sustained VT, suggest a causative link between underlying ischemia produced by a chronically occluded coronary artery and provocation of VT and lend supportive evidence to this treatment approach.

Outcomes and Computed Tomography Scan Follow-Up of Bioresorbable Vascular Scaffold for the Percutaneous Treatment of Chronic Total Coronary Artery Occlusion

Everolimus-eluting bioresorbable vascular scaffold (BVS) implantation in chronic total occlusion (CTO) could provide theoretical advantages at follow-up compared with metallic stents. This study aimed to assess the feasibility of BVS use for the percutaneous treatment of CTO by analyzing clinical outcomes and patency at midterm follow-up. From February 2013 to June 2014, 42 patients with 46 CTOs were treated by BVS implantation. Once the guidewire reached the distal lumen, all the occluded segments were predilated. Postdilation was performed in all patients. A multislice computed tomography was scheduled for all patients at 6months. The mean age was 58 ± 9years, 41 (98%) were men and 14 (33%) diabetic. The target vessel was predominantly the left anterior descending artery (22, 48%). According to the Japanese-CTO score, 21 CTOs (46%) were difficult or very difficult. Most cases were treated with an anterograde strategy (34 lesions, 74%). A hybrid procedure with a drug-eluting stent at the distal segment was the applied treatment in 7 CTOs (15%). The mean scaffold length was 43 ± 21mm. Technical success was achieved in 45 lesions (98%),and 1 patient (2.4%) presented a non-Q periprocedural myocardial infarction. Re-evaluation was obtained in all patients at 6 ± 1months. Two re-occlusions and a focalrestenosis were identified. After 13 ± 5months of follow-up, there were 2 repeat revascularizations (4.8%). Neither death nor myocardial infarction was documented. In conclusion, BVS for CTO seems to be an interesting strategy with a high rate of technical success and low rate of cardiac events at midterm follow-up in selected patients.

Guide catheter-induced aortic dissection complicated by pericardial effusion with pulsus paradoxus: a case report of successful medical management.

Aortic dissection is a rare but potentially fatal complication of percutaneous coronary intervention (PCI). Management strategies of PCI induced dissection are not clearly identified in literature; such occurrences often mandate surgical repair of the aortic root with reimplantation of the coronary arteries. Another trend seen in case reports is the use of coronary-aortic stenting if such lesions permit. Several factors impact the management decision including the hemodynamic stability of the patient; mechanism of aortic injury; size, severity, and direction of propagation of the dissection; presence of an intimal flap; and preexisting atherosclerotic disease. We describe a case of a 65-year-old woman who underwent PCI for a chronic right coronary artery (RCA) occlusion, which was complicated by aortic dissection and pericardial effusion. Our case report suggests that nonsurgical management may also be appropriate for PCI induced dissections, and potentially even those associated with new pericardial effusion.

ASSA14-12-12 The analyses of incidence of failure and relate factors in patients with retrograde wire for the treatment of chronic coronary artery occlusion

<h3>Background</h3> To evaluate the incidence of failure and related factors in patients with regrograde wire technique for the treatment of chronic coronary artery occlusion. <h3>Methods</h3> The data of 170 CTO patients undergoing retrograde PCI for a CTO from August 2004 to October 2013.170 cases with chronic coronary artery occlusion underwent transcutaneous coronary artery intervention (PCI) therapy by retrograde wire technique were enrolled in this study (male: 97, mean age: 60.6 ± 11.3 years). Failure is defined as wire is unable to pass through the occlusion of the target – artery or retrograde wire is unable to find the collateral circulation of miraclechannel. And the procedure is failed in stent implantation. We assessed the plasticity and determinants of retrograde wire technique of PCI <h3>Results</h3> The data of 170 CTO patients undergoing retrograde PCI for a CTO from August 2004 to October 2013 were analysed. The average occlusion time lasts more than 3.3 years, including 70 LAD CTO and 88 RCA CTO. Retrograde wire technique was failued to performe in 26 patients with chronic coronary artery occlusion. The average of 26 patients were treated by 4.3 guidewires, 1.2 microcatheters and intravascular contrast media 210 ml. there were no significantly changes about left atrial (LA)diameter and and left ventricular (LV) ejection fraction (p &gt; 0.05) between success group and failue group. There were 26 patients (26/170, 15.2%) with at least one reason, including 17 cases with the wire is unable to pass through the collosion; 2 cases with small right coronary artery; 7 cases with bad collateral miraclechannel. In logistic regression analysis, the occlusion time between 3–12 months and whether the target artery had received antigrade wire technique before were the independent predictors of failure rate. <h3>Conclusions</h3> According to the data, the success rate of the occlusion time between 3–12 months is the lower than 1–3 years. There is no difference of the success rate between occlusion segment ≥15 mm and &lt;15 mm, which is different from the previous view. Retrograde wire technique significantly increases the success rate of procedure in patients who failed in antegrade wire technique.

GW25-e4485 The analyses of incidence of failure and relate factors in patients with retrograde wire for the treatment of chronic coronary artery occlusion

GW25-e4485 The analyses of incidence of failure and relate factors in patients with retrograde wire for the treatment of chronic coronary artery occlusion

Association of blood level of inflammatory mediators and morphology of coronary artery stenosis in patients with stable angina

Aim. To study the association of morphology of coronary artery disease and pentraxin-3, tumor necrosis factor α blood levels in patients with stable angina who undergo coronary artery bypass surgery. Methods. The study included 92 patients aged 44-73 years with stable angina of II-III functional class. The coronary artery disease type was classified by AHA/ACC criteria: type A - concentric stenosis with flat plague and plague length less than 10 mm, type B - eccentric stenosis or blunt-edged stenosis with moderate calcinosis or signs of mural trombosis, with length not exceeding 200 mm, type C - stenosis with plague length over 20 mm, plague ulceration, marked calcinosis, diffuse lesions, chronic coronary artery occlusion. Pentraxin-3, tumor necrosis factor α blood levels were measured by ELISA in all patients before the surgery, 8 and 24 hours after the surgery. Results. There was a relation found between the type of stenosis and pentraxin-3 and tumor necrosis factor α blood levels. In patients with С type stenosis, pentraxin-3 blood level was 4 times higher (p 0.001) 24 hours after the coronary artery bypass surgery compared to patients with A type stenosis, and by 1.8 and 1.3 times higher compared to patients with В1 and В2 stenosis type, accordingly. Conclusion. There was a close relation revealed between the morphology of coronary artery stenosis and pentraxin-3 and tumor necrosis factor α blood levels in patients with stable angina.