PROGNOSTIC BLOCK-SCHEME OF CLINICAL OUTCOME OF ACUTE CORONARY SYNDROME INTO NON-Q-INFARCTION. Part II

Aim. An invention of block-scheme of short-term personified prognosis of clinical outcome of acute coronary syndrome (ACS) into non-Q-myocardial infarction at hospital stage

Material and methods. Totally 68 patients included, with CHD diagnosis. As prognostic factors were taken the most informative intervals of concentrations of the parameters of subclinical nonspecific inflammation, endothelial dysfunction, cardiospecific changes in immune system and serum cardiomarkers. To test the parameters listed we used the method of hard-phase immune-enzyme analysis. The value of relative risk (RR) with confidence intervals (CI), value of absolute risk (AR), diagnostic efficacy (DE) of the applied methods were calculated in accordance to the clinical outcome of ACS into nonQ-MI together with the risk factor studied (concentration intervals). Statistical data processing was done with Statistica (v. 6.0) and “Biostat4.03”.

Results. Based on the complex analysis of the obtained results we invented a blockscheme for short-term personified prognosis of clinical outcome of ACS into non-Q-MI. It included the most significant intervals of concentrations of the parameters studied. Personified short-term prognosis of ACS into non-Q-MI during in-hospital stage is related to the concentration intervals: TP-I from 2,2 to 2,5 ng/ml; C-RP– from 15 to 20 mg/L;IL-1β — from 0 to 1 pg/ml; TNF-α— from 0,6 to 1 pg/ml; NO– from 12 to 20 mcM/L;ММР-9— from 400 to 600 ng/ml; TIMP-1— from 120 to 150 ng/ml; HC – from 15 to 17 mcM/L; NP – from 17 to 26 nM/L; AB to CL – from 7 to 10 U/ml and in 68% cases there are AB against cardiomyocytes. Patients having the parameters listed, at the moment of admittance, are in the high risk group for clinical outcome of ACS into non-Q-MI.

Conclusion. In the cases when during admittance the parameters of inflammation, endothelial dysfunction, serum cardiomarkers and immune markers get in the concentration intervals included into the block-scheme, these patients do not relate to a high risk group of clinicl outcome of ACS to non-Q-MI. This makes even at the early stage of hospitalization to perform treatment procedures in accordance to the standarts of management of occluded coronary vessels that lead to large-area non-Q-MI.

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