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Khirurgii

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Year 2020 Vol. 28 No 4

GENARAL & SPECIAL SURGERY

A.R. PRUDNIKOV, A.N. SHCHUPAKOVA, G.D. KOROBOV

PREDICTING OF REPEATED CARDIOVASCULAR EVENTS WITHIN 1 YEAR AMONG PATIENTS WITH MYOCARDIAL INFARCTION AFTER CORONARY ARTERY STENTING

Vitebsk State Medical University, Vitebsk,
The Republic of Belarus

Objective. To design the model to predict the recurrent cardiovascular events within 1 year including parameters of the cytokine profile and immune system in patients with myocardial infarction after coronary artery stenting.
Methods. The patients (n=23) with the diagnosis of myocardial infarction, verified according to coronary angiography, electrocardiogram results and biochemical blood test took part in the study. The stent-application procedure of symptom-related coronary arteries was performed in all symptomatic patients. The levels of interleukins 4, 6, 8, 10 and 18, tumor necrosis factor alpha (TNF-α), vascular adhesion molecule sVCAM-1, immune system parameters (T- and B- cell immunity, IgA, IgG, IgM, phagocytic number, phagocytic index of leukocytes, circulating immune complexes), activity of neutrophil elastase and BAPNA-amidase in blood serum were evaluated.
Results. Discriminant analysis with «Classification trees» revealed that age, IL-6 level and IgG could be used as parameters (reference values) for assigning patients to the group of high or low risk of recurrent cardiovascular disease. Thus, patients over 52 years old with IL-6 levels less than 1.19 pg/ml and more than 4.83 pg/ml and IgG levels more than 9.075 g/l are at high risk. An unfavorable outcome is predicted in 100% of cases, favorable – in 80% of cases, and 88.5% is the percentage of correct prognosis. Based on the obtained results of logistic regression using with subsequent ROC analysis of the studied factors, the prediction model includes the age of patients, the level of IL-6, IgG, circulating immune complexes, the number of active T-lymphocytes (CD3+CD4+HLA-DR+), and the phagocytic index of leukocytes AUC of the model (area under the curve) = 0.845 (95% CI 0.645-1.0), sensitivity – 80%, specificity – 90.9% was designed.
Conclusion. The designed model allows predicting the occurrence of recurrent cardiovascular events in patients with myocardial infarction within 1 year after coronary artery stenting.

Keywords: prediction, cardiovascular events, stenting, immune system, myocardial infarction
p. 377-386 of the original issue
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Address for correspondence:
210009, Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Internal Diseases
tel. +375 029 515-80-15,
e-mail: prudnikov92@yandex.ru
Prudnikov Alexander R.
Information about the authors:
Prudnikov Alexandår R., Assistant of the Department of Internal Diseases, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-9458-0867
Shchupacova Alina N., MD, Professor of the Deparnment of Internal Diseases, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-7938-0610
Korobov Gennadii D., PhD, Associate Professor of the Training Center for Practical Training and Simulation Training, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-6878-7573
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