[The role of cytokines in improvement of coronary restenosis risk stratification after endovascular stenting in patients with ischemic heart disease].
OBJECTIVE
To evaluate diagnostic and prognostic significance of the levels of proinflammatory cytokines (IL-1, IL-6, TNF-alpha) in improvement of stratification, i.e. determination of coronary restenosis risk in patients with ischemic heart disease 18 months after coronary artery (CA) stenting. The patients were divided into two groups: group 1 consisted of 30 patients with ischemic heart disease and symptoms of anginal recurrence, 38 patients of group 2 had no recurrent coronary insufficiency. Baseline examination of 68 patients with ischemic heart disease and their examination 6-24 months (18.1 +/- 1.9 months) after CA stenting were performed.


RESULTS
High activation of the proinflammatory cytokines in patients with postinfarction cardiac dysfunction and after CA stenting is associated with a high rate of recurrent angina, deterioration of myocardial perfusion, progression of atherosclerosis in CA native bed. Restenosis of CA stents in patients after endovascular myocardial revascularization significantly more frequently correlates with elevated blood levels of IL-6 by 56.8% (p = 0.031). Patients with anginal recurrence caused by stent restenosis, progression of atherosclerosis in native CA developed high expression (10.2-58.1%) of TNF-alpha (p = 0.038) 18 months after endovascular revascularization. Repeated angioplasty is associated with multiple CA affection (k = 0.56, p = 0.004) and predilation before stenting (k = 0.3; p = 0.001).


CONCLUSIONS
Dynamics of proinflammatory cytokines (IL-1, IL-6 and TNF-alpha) is efficient to use in complex diagnosis for better stratification of CA restenosis risk in endovascular stenting of patients with coronary artery disease.
Tepliakov
A T
AT
Rybal'chenko
E V
EV
Suslova
T E
TE
Mamchur
S E
SE
D000328:Adult; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D016207:Cytokines / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D009204:Myocardial Revascularization / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012800:Siberia / Q000453:epidemiology; D015607:Stents; D013997:Time Factors
D016207:Cytokines