The objective was to find out the value of the markers that reflect the pathophysiology of destabilization of ischemic heart disease in risk stratification and access the effectiveness of the secondary prevention.
This prospective study included 180 hospitalized patients (M/F=120/60, 57±3) with UA and low to intermediate Grace score. End-points were cardiac death, myocardial infarction, urgent revascularization, recurrent UA, life threatening arrhythmias. In our previous work we developed the predictors for 12 months MACE. They were myeloperoxidase>335 pmol/l (OR 12,5; 95% CI 4,5;35, p<0,0001), von Willebrand factor>147%(OR 10,9; 95% CI 3,6;32,8, p<0,0001), homocysteine>14,5mmol/l(OR 7,1; 95% CI 2,5;20,2, p=0,0002), BNP>111 pg/ml(OR 8,5; 95% CI 2,1;34,9, p=0,03). According to the cut-off values we investigated the scale for prediction of adverse outcomes in patients with UA (AUC 0,822; sensivity 80%, specificity 98%). We investigated the schemes of individualized secondary prevention on the basis of elevated biomarkers (dosage of statins, vitamins B6 and B12, clopidogrel and aspirin sensivity assessment).
Conclusion: Multimarker approach can help in decision making in intermediate and low risk UA patients and to access the effectiveness of preventive therapy.