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  • Title: [Diagnostic and prognostic value of atherosclerosis risk factors for predicting 1 year outcome in patients with acute myocardial infarction and in patients with stable coronary artery disease receiving percutaneous transluminal coronary angioplasty].
    Author: Drobniak-Hełdak D, Kolasińska-Kloch W, Rajtar-Salwa R.
    Journal: Folia Med Cracov; 2009; 50(3-4):43-54. PubMed ID: 21853870.
    Abstract:
    Acute coronary syndrome as unstable angina and myocardial infarction are the clinical manifestations of destabilization of coronary atherosclerotic plaques. Optimal medical treatment (OMT) in addition to percutaneous transluminal coronary angioplasty (PTCA) with stent implantation decreased risk of cardiovascular mortality. This study was undertaken for searching the new cardiac risk factors to assess the clinical outcome in patients with acute myocardial infarct and stable angina receiving PTCA with stent implantation. The study included a sort group of 68 men, 26 with acute myocardial infarct (AMI), 29 with stable angina (SA) and 13 healthy men (K). Patients were treated with transluminal coronary angioplasty with stent implantation and continued standard pharmacological treatment. Measurements were taken at admission (baseline) and at 7 and 28 days (post-stress) after successful PTCA. Levels of IMA/ALB, hsCRP, CK, CK-MB, Troponin I, albumin, antioxidant potency parameters (FRAP, SH) and oxidative stress parameters (LOOH, IMA) were analyzed in serum from all patients. Our study demonstrated significantly higher serum IMA/ALB ratio in AMI group in comparison to SA group and controls. Categorized histogram revealed the highest IMA frequency in patients with angiographically confirmed stenosis compared to examined control subjects. IMA value tended to decrease in post-stress period but still remained the highest in AMI group as compared to controls. IMA concentrations were inversely correlated with heart ejection fraction, plasma antioxidant potential parameters (FRAP, SH) and positively correlated with CK and CKMB values. The comparative 1 year outcomes documented clinical failure in 19% vs. 52% of patients in AMI and SA groups respectively. The overweight and low antioxidant potency reached the statistical significance relevant to restenosis and cardiovascular events in SA group. Our data suggest that IMA levels in the course of myocardial ischemia treatment by PTCA may be useful as a discriminating marker for definition of the high risk group of patients with suspected cardiovascular complications.
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