The lipid-lowering therapy effectiveness and IHD course after coronary stenting

Authors

  • A. S. Skoromna SE "Dnipropetrovsk medical academy Ministry of Health of Ukraine", Ukraine
  • A. V. Khomych ГУ «Днепропетровский областной клинический центр кардиологии и кардиохирургии», Ukraine
  • S. V. Romanenko ГУ «Днепропетровская медицинская академия МЗ Украины», Ukraine
  • O. A. Koval ГУ «Днепропетровская медицинская академия МЗ Украины», Ukraine

DOI:

https://doi.org/10.26641/2307-0404.2013.2.15947

Keywords:

chronic ischemic heart disease, coronary stenting, lipid profile, statins

Abstract

Objective: to examine the relationship between the achievement of goal lipid metabolism and incidence of adverse cardiovascular events in patients after successful coronary stenting. Materials and Methods: The database for the study was data from 198 histories of patients with various forms of ischemic heart disease, who underwent coronary angiography,306 stents implanted in coronary arteries in a regional cardiology center and Mechnikov regional hospital, Dnepropetrovsk over the period from 2004 to 2008. The period of observation of patients was on average 4,6 ± 1,3 years. Results and Discussion: The study found that the best five-year survival rate of patients without adverse cardiovascular events after stenting was significantly associated with previous PCI, presence of stable angina not higher than 2nd FC (61%, p<0,0001), achieving target level of CH-LDL (35%, p = 0.014), TG level less than 1,7 mmol/l was associated with a sta­tistically significant reduction in risk of the primary endpoint 0,68 (long-rank p <0,0001) while taking statins after stenting. Conclusions: Achieving level of total cholesterol less than 4.5 mmol / L was not significantly associated with a decrease in the frequency of adverse CAP after successful stenting, but the level of 5-year survival was significantly associated with the achievement of target levels of LDL cholesterol, less than 2.5 mg/dL and triglycerides less than 1.7 mmol/l.

Author Biographies

A. S. Skoromna, SE "Dnipropetrovsk medical academy Ministry of Health of Ukraine"

Hospital therapy department N 1 and occupational pathology

S. V. Romanenko, ГУ «Днепропетровская медицинская академия МЗ Украины»

Кафедра госпитальной терапии №2
(зав. – академік НАМН України, д. мед. н., проф. Г.В. Дзяк)

O. A. Koval, ГУ «Днепропетровская медицинская академия МЗ Украины»

Кафедра госпитальной терапии №2
(зав. – академік НАМН України, д. мед. н., проф. Г.В. Дзяк)

References

Амосова Е.Н. Эфективность коррекции факто-ров риска и различных методов хирургического лече-ния больных хронической ИБС в отношении пре-дотвра¬щиения смерти и инфаркта миокарда: мифы и реальность / Е.Н. Амосова // Серце і судини. – 2009.– № 4. – С. 12-34.

Коваленко В.М. Регіональні особливості рівня здоров’я народу України / В.М. Коваленко, В.М. Кор-наць¬кий. – К.: Нац. наук. центр «Ін-т кардіології імені акад. М.Д. Стражеска», 2011. – 65 с.

Коваленко В.М. Серцево-судинні захворю-вання. Рекомендації з діагностики, профілактики та лі-ку¬вання / В.М. Коваленко, М.І. Лутай – К.: МОРІОН, 2011. – 408 с.

Леонов В.П. Применение статистики в статьях и диссертациях по медицине и биологии. Ч. II. Исто-рия биометрии и ее применения в России / В.П. Лео¬нов // Междунар. журнал мед. практики. – 2007. – № 4. – С.19.

Лутай М.И. Ведение больных с ишемической болезнью сердца и сопутствующей артериальной ги-пер¬тензией в Украине. Результаты исследования ПРЕСТИЖ / М.И. Лутай // Укр. кардіол. журнал. – 2011. – № 1. – С.25-36.

Методические рекомендации Ассоциации кар-дио¬логов Украины. Дислипидемии: диагностика, про-филактика и лечение. – К., 2007. – 45 с.

Atorvastatin Versus Revascularization Treatments (AVERT) Trial. Presented at. The American Heart As¬sociation. Scientific Sessions. [Электронный ресурс], режим доступа к ресурсу: www.clinicaltrialresults. Org/slides/avert.

Benefit of intensive statin therapy in women: results from PROVE IT-TIMI 22 / Q.A. Truong, S.A. -Murphy, C.H. McCabe, A. Armani, C.P. Cannon // Circulation. – 2011. – Vol. 4, Issue 3. – P. 328-336.

COURAGE. Clinical Outcomes Utilizing. Revas-cularization and. Aggressive Guideline-Driven. Drug Eva-luation. The First Coronary Angioplasty for Stable CAD[Электронный ресурс], режим доступа к ресурсу www.clinicaltrialresults.org/Slides/COURAGE

Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 parti¬cipants in 26 randomised trials/ Cholesterol Treat-ment Trialists' (CTT) Collaboration // Lancet.—2010.—Vol.376, issue 9753.—P. 1670-1681.

ESC/EAS Guidelines for the management of dyslipidaemias/ Zeljko Reiner, Alberico L. Catapano, Guy De Backer [et al.] // Eur. Нeart J. – 2011. – Vol. 32. –P. 1769-1818.

MASS II. Randomized: [ Электронный ресурс], режим доступа к ресурсу: www.clinicaltrialresults. Org/slides/MASS

Relationship of Oxidized Phospholipids and Bio-markers of Oxidized Low-Density Lipoprotein With Car-dio¬vascular Risk Factors, Inflammatory Biomarkers, and Effect of Statin Therapy in Patients With Acute Coronary Syndromes: Results From the MIRACL (Myocardial Ischemia Reduction With Aggressive Cholesterol Lo-wering) Trial / Alexander E. Fraley MD, Gregory G. Schwartz MD, PhD, Anders G. Olsson MD, PhD [et al.] // JACC. – 2009. – Vol. 52, Issue 23. – P. 2186-2196.

Risk of late stent thrombosis continues for up to 7 years in patients with first generation drug-eluting stents; risk factors identified: (Материалы конгр. транска-тетерной кардиоваск. терапии «TCT2011»), [Элек-трон¬ный ресурс]/Ron Waksman, Martin Leon // EurekAlert.—

Nov.2011.—Режим доступа к журналу: http://www.eurekalert.org/pub_releases/2011-11/crf-rot110911.php.

Non-adherence to dual antiplatelet therapy fol-lowing percutaneous coronary intervention results in hig-her rates of ischemic and bleeding events:(Материалы конгр. транскатетерной кардиоваск. терапии «TCT2011»), [Электронный ресурс] / Roxana Mehran // Me¬dical¬Xpress.—2011.—Режим доступа к журн.: http://medicalxpress.com/news/2011-11-results-paris-registry-tct.html

RITA-2 Trial. PTCA vs. Medical Management of 1018 Stabilized Angina Patients. RITA-2 Trial Parti-cipants: Lancet;350 [Электронный ресурс], режим дос-тупа к ресурсу: www.clinicaltrialresults. Org/slides/tactics-timi

Simple Scoring Scheme For Calculating The Risk Of Acute Coronary Events Based On The 10-Year Fol-low-Up Of The Prospective Cardiovascular Münster (Pro-cam) Study .Электронный ресурс, режим доступа к ресурсу www.clinicaltrialresults.org/Slides/ Procam.

Swiss Interventional Study On Silent Ischemia Type[ Электронный ресурс],режим доступа к ресурсу: www.wikidoc.org/index.php/SWISSI_II

Triglycerides and the risk of coronary heart di-sease. 10158 incident Cases Among 262525 Parti¬cipants in 29 Western Prospective Studies / N. Sarwar, J. Danesh, G. Eiriksdottir [et al.] // Circulation. – 2007. – Vol. 115. – P. 450-458.

Amosova EN. Efektivnost korrektsii faktorov riska i razlichnyih metodov hirurgicheskogo lecheniya bolnyih hronicheskoy IBS v otnoshenii predot¬vra¬schie-niya smerti i infarkta miokarda: mifyi i realnost. Sertse i sudini. 2009;4:12-34.

Kovalenko VM, Kornatskiy VM. Regionalni oso-b¬livosti rivnya zdorov’ya narodu Ukrayini. K: Nats nauk tsentr «In-t kardiologiyi imeni akad MD Strazheska». 2011;65.

Kovalenko VM, Lutay MI. Sertsevo-sudinnI zah-voryuvannya. Rekomendatsiyi z diagnostiki, profilaktiki ta likuvannya. K: MORION. 2011;408.

Leonov VP. Primenenie statistiki v statyah i dis-sertatsiyah po meditsine i biologii. Ch II istoriya biometrii i ee primeneniya v Rossii. Mezhdunar zhurnal med prak-tiki. 2007;4:19.

Lutay MI. Vedenie bolnyih s ishemicheskoy bo-leznyu serdtsa i soputstvuyuschey arterialnoy gipertenziey v Ukraine. Rezultatyi issledovaniya PRESTIZh Ukr kardiol zhurnal. K: Chetverta hvilya. 2011;1:25-36.

Metodicheskie rekomendatsii assotsiatsii kardio-logov Ukrainyi. Dislipidemii: diagnostika, profilaktika i lechenie. K. 2007;45.

Atorvastatin versus revascularization treatments (AVERT) Trial Presented at. The American Heart Asso-ciation. Scientific Sessions: www.clinicaltrialresults. Org/slides/avert.

Truong QA, Murphy SA, McCabe CH, Arma¬ni A, Cannon CP. Benefit of intensive statin therapy in wo-men: results from

PROVE IT-TIMI 22. Circulation. 2011;4(3):328-36.

COURAGE. Clinical Outcomes Utilizing. Revas-cularization and. Aggressive Guideline-Driven. Drug Eva-luation. The First Coronary Angioplasty for Stable CAD. www.clinicaltrialresults.org/Slides/COURAGE.

Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Cholesterol Treat-ment Trialists' (CTT)

Collaboration. Lancet. 2010;376(9753):1670-81.

Zeljko Reiner, Alberico L Catapano, Guy De Backer. ESC/EAS Guidelines for the management of dyslipidaemias. European heart J. 2011;32:1769-1818.

MASS II. Randomized: www.clinicaltrialresults. Org/slides/MASS.

Alexander E, Fraley MD, Gregory G, Schwartz MD, PhD, Anders G Olsson MD, PhD. Relationship of Oxidized Phospholipids and Biomarkers of Oxidized Low-Density Lipoprotein With Cardiovascular Risk Fac-tors, Inflammatory Biomarkers, and Effect of Statin Therapy in Patients With Acute Coronary Syndromes: Results From the MIRACL Myocardial Ischemia Re-duction With Aggressive Cholesterol Lowering. Trial. JACC. 2009;52(23):2186-96.

Ron Waksman, Martin Leon. Risk of late stent thrombosis continues for up to 7 years in patients with first generation drug-eluting stents, risk factors identified: EurekAlert; 9 Nov 2011.

Roxana Mehran. Non-adherence to dual an-tiplatelet therapy following percutaneous coronary inter-vention results in higher rates of ischemic and bleeding events: http://medicalxpress.com/news/2011-11-results-pa¬ris-registry-tct.html. MedicalXpress; 2011.

RITA-2 Trial. PTCA vs. Medical Management of 1018 Stabilized Angina Patients. RITA-2 Trial Parti¬ci-pants: Lancet, 350: www.clinicaltrialresults. Org/slides/tactics-timi.

Simple Scoring Scheme For Calculating The Risk Of Acute Coronary Events Based On The 10-Year Follow-Up Of The Prospective Cardiovascular Münster (Procam) Study: www.clinicaltrialresults.org/Slides/ Procam.

Swiss Interventional Study On Silent Ischemia Type: www.wikidoc.org/index.php/SWISSI_II.

Sarwar N, Danesh J, Eiriksdottir G. Triglycerides and the risk of coronary heart disease. 10158 incident Cases Among 262525 Participants in 29 Western Pro-spective Studies. Circulation. 2007;115:450-8.

Published

2013-07-30

How to Cite

1.
Skoromna AS, Khomych AV, Romanenko SV, Koval OA. The lipid-lowering therapy effectiveness and IHD course after coronary stenting. Med. perspekt. [Internet]. 2013Jul.30 [cited 2024Apr.19];18(2):46-54. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/15947

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Section

CLINICAL MEDICINE