Purpose: To perform a prospective comparative analysis of lipid profiles, markers for inflammation and endothelial dysfunction in groups of coronary artery disease (CAD) patients with and without episodes of unstable coronary blood flow after percutaneous coronary intervention (PCI); and to detect factors which may be used as predictors of cardiovascular complications.
Methods: A total of 95 patients aged 60.47±9.54 years with CAD and stable angina were divided into two groups. Group 1 included patients with CAD without episodes of unstable coronary blood flow after PCI (n=77) and group 2 included CAD patients with episodes of unstable coronary blood flow after PCI (n=18). All patients were matched by age, CAD duration, diabetes mellitus, blood pressure levels and smoking history.
Results: Laboratory tests were performed before PCI and 12±2.4 month after. The level of lipoprotein (a), HDLC, FNO-a equally decreased in both groups. In patients of group 2 compared to group 1 there were observed significantly increased levels of atherogenic indices of the lipid profile (total cholesterol, LDL) and inflammation markers: high-sensitivity C-reactive protein, homocysteine, levels of soluble CD40 ligand (CD40L), interleukin-1β interleukin- B6, and decreased levels of nitrites. Significant correlations of inflammatory markers and endothelial dysfunction with body-weight index, family history of CAD, significant multivessel stenosis, number of angina attacks per week and presence of diabetes mellitus were revealed in group 2. Multivariate logistic regression analysis revealed that patients with unstable angina at baseline had the risk of unstable coronary blood flow after PCI 4 times higher (p=0.02).
Conclusion: The inflammatory markers: C-reactive protein, homocysteine, CD40L can initiate unstable coronary blood flow after coronary angioplasty and stenting.