Risk Assessment of Cardiac Events in Patients with Stable Ischemic Heart Disease After Percutaneous Coronary Intervention, Accompanied by Myocardial Damage

Background. Percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) is followed often by myocardial injury. Up to now there is no mutual agreement to the infl uence of the perioperative myocardial injury on the long-term prognosis of the IHD patients.

Objective. The aim of study was to assess the risk factors for the development of cardiac events in the long-term period in patients with stable coronary artery disease with myocardial damage after PCI.

Materials and methods. The study included 113 patients with stable coronary artery disease who underwent planned PCI. Serum troponin levels were determined before and 24 hours after the intervention. Re-examination of patients was carried out after 12–18 months (average 15 months).

Results. The post PCI Tn I level over a reference one was registered in 25 patients (22,2 %). During the follow-up period the cardiovascular events took place in 25,6 % patients: acute myocardial infarction (MI) in 3 (2,6 %), angina occurred in 23 %. One-way ANOVA revealed a signifi cant value for cardiac risk events of the patient age, number of stenosed arteries, summary degree of stenosis, and their complicity, number of implanted stents. The fi rst three of them were included in the fi nal combination of the stepwise discriminant analysis. The general linear model of the latter detected additionally statistical signifi cance of the variables “MI in the past” (before PCI) and “number of postdilatations“.

Conclusion. In patients with stable ischemic heart disease, included in the study, the determining risk factors for the development of cardiac events were the prevalence and nature of the obstructive lesion of the coronary bed, age, previous myocardial infarction, and especially the performance of PCI. Myocardial damage was not identifi ed as a risk factor for recurrent angina or myocardial infarction.

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