Early and long-term clinical outcomes in patients with unstable angina and coronary artery stenting

Aim. To study early and long-term clinical outcomes in patients with unstable angina (UA) and coronary artery stenting based on the results of a seven-year follow-up.
Materials and Methods. The study included 165 patients with UA and coronary artery stenting. The average age of patients was 59.04±10.34 years; the number of male patients was 129 (78.2%). The risk by the GRACE scale was 96.9±17.46 points. The average number of affected coronary arteries was 2.23±1.07 per person, the average number of implanted stents was 2.10±1.45 per person, the average length of the stented area was 43.12±25.6 mm. Everolimus- or sirolimus-eluting stents were used. All patients were assessed for troponin I, myeloperoxidase, and C-reactive protein; platelet, plasma, and vascular hemostasis were evaluated. The patients underwent echocardiography, coronary angiography. The follow-up period was 7±1.6 years.
Results. During a 7-year follow-up period, with endovascular treat ment strategy and double antithrombotic therapy with clopidogrel 75 mg and acetylsalicylic acid 75 mg repeated UA developed in 91 (55.2%) pts and myocardial infarction was registered in 21 (12.7%) pts. Cardiovascular mortality was 7.3%. Independent stent thrombosis risk predictors included AUC ADR test ≥ 77.5 U, troponin I ≥ 0.90 ng/ml, total length of the stented area ≥ 60 mm. Independent predictors of the development of restenosis/neoatherosclerosis included: more than 4 implanted stents per patient (RR 1.440; 95% CI 1.233-1.681), the total length of the stented area ≥ 60 mm (RR 1.532; 95% CI 1.245-1.884), homocysteine ≥ 14 µmol/l (RR 1.479; 95% CI 1.168-1.876), myeloperoxidase ≥ 300 pmol/l (RR 1.351; 95% CI 1.102-1.656), with risk factors including a history of coronary heart disease for more than 5 years (RR 13.011; 95% CI 4.226-40.050), diabetes mellitus (RR 1.367; 95% CI 1.136-1.647).
Conclusion. The number of early and long-term coronary events in patients with unstable angina and coronary artery stenting was estimated. Predictors of stent thrombosis, restenosis and the formation of new atherosclerotic plaques outside the stenting zone were identified.

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