Coronary heart disease continuous to take the leading position in the world as the cause of death and early disablement of persons able to work, in spite of active introduction of modern methods of diagnostics and treatment.
Now a days in the treatment of coronary heart disease actual problem is both surgical and endovascular revascularization. Stents introduction with drug covering allows to show the priority of endovascular surgery in the chose of the methods of the coronary artery passage restoration.
In spite of the endovascular surgery progress high percents of complication stays after percutaneous coronary angioplasty.
The most often restenose of coronary arteries is takes place, which according to the statistics is developed during first 6 month after percutaneous coronary angioplasty in 20–40 % of patients [1–3], and in complicated injuries of coronary arteries it reaches 60 % [4].
The aim of the research: the estimation of coagulative factors influence and factors of inflammation on the risk elevation of restenosis.
Materials and methods of the research. 100 males of Karaganda region who unevened the procedure of stenting of coronary arteries in connection with acute myocardial infarction were examined.
Questionnaire of the patients was made paying attention to finding of risk factors of coronary heart disease: smoking, arterial hypertension and hereditary factors of cardiovascular pathology. Biochemical findings of lipid specter, coagulogramms, C-reactive protein and changing of throbocyte level were estimated.
All the patients were divided to two groups: 50 persons each. The 1st group consisted the patients with restenosis of coronary arteries determined by coronarography during 1 year after stenting in connection with the repeated episode of acute coronary syndrome; the 2nd group consisted with the patients without the signs of restenosis.
Results of research and their discussion. According to the questionnaire it was determined, that in the 1st group there were 44 % of smokers, but in the 2nd group the factor of smoking was only in 17 %. Hereditary factors to coronary heart disease was higher in the 1st group (64 %) in comparison with the 2nd group (50 %). Special attention was payed to that the arterial hypertension was more often in the 1st group too (64 %).
The signs of hypercoagulation were seen in 36 % in the 1st group, but in the 2nd group there were only 20 % of cases. Moderate level of thrombocytosis was seen in each 2nd patients of the 1st group and in each 4th patients of the 2nd group.
It necessary to mark that in the 1st group in 100 % of patients the elevation of C-reactive protein was registrated. At the same time in the 2nd group no one case with signs of inflammatory syndrome were marked by clinical and laboratory examinations.
Conclusions
1. Clinico-biochemical prognostic factor of possible development of restenosis of coronary arteries may be the elevation of C-reactive protein, hypercholesterinemia, hypertrigliceridemia, hyperlipoproteidemia and inclination to hypercoagulation.
2. The elevation of thrombocyte level may also be possible factor, as intervation of thrombocyte aggregation, including stenting zone.
3. Marked clinical and laboratory damages are to be seen as indications for making of coronarography for the diagnosis of possible restenosing.