Abstract
The article describes three clinical cases with an analysis of the causes of development of adverse cardiovascular
events after percutaneous coronary interventions (PCI). Analysis of the three cases of unfavorable cardiac
complications developed in the mid-long term after PCI, due to the formation of stent restenosis, the
progression of coronary atherosclerosis and stent thrombosis, shows a significant role in the development of
these complications of increased functional activity of platelets against antiplatelet therapy, failure to achieve
target levels lipid spectrum (mostly low density lipoproteins and total cholesterol levels) against statin therapy,
and wear polymorphic alleles LPL, ApoE and ACE.
The above observations and clinical experience once again confirm the necessity of monitoring the reactivity
of platelets in patients directed to PCI and the effect of increased residual reactivity of platelets on the development
of adverse cardiovascular events after PCI. In addition, patients directed to percutaneous coronary
interventions need regular monitoring of the lipidogram to control the effectiveness of lipid lowering therapy
and correction of lipid-lowering therapy regimens to achieve target lipid levels. The analysis of the three presented
observations once again shows the necessity of approaching genetic testing to clinical practice.
References
- Welt F.G., Sass C., Herbeth B., Siest G., Visvikis S. Lipoprotein lipase (C/G) 447 polymorphism and blood pressure in the stanislas cohort. J. Hypertens. 2000; 18: 1775–81.
-
Welt F.G., Rogers C. Inflammation and restenosis in the stent era. Arterioscler. Thromb. Vasc. Biol. 2002; 22: 1769–76.
-
Kusunoki M., Tsutsumi K., Natsume Y., Tsutsui H., Miyata T., Oshida Y. Lipoprotein lipase and atherosclerosis. Intern. J. Collabor. Res. Int. Med. Public Health. 2015: 9 (7).
-
Monraats P.S., Rana J.S., Nierman M.C., Pires N.M., Zwinderman A.H., Kastelein J.J. et al. Lipoprotein lipase gene polymorphisms and the risk of target vessel revascularization after percutaneous coronary intervention. J. Am. Coll. Cardiol. 2005; 46: 1093–100. DOI: 10.1016/j.jacc.2005.05.071
-
Ward H., Mitrou P.N., Bowman R., Luben R., Wareham N.J., Khaw K.T. et al. APOE genotype, lipids, and coronary heart disease risk: a prospective population study. Arch. Intern. Med. 2009; 169: 1424–9. DOI: 10.1001/archinternmed.2009.234
-
Christidis D.S., Liberopoulos E.N., Kakafika A.I., Miltiadous G.A., Cariolou M., Ganotakis E.S. et al. The effects of apolipoprotein E polymorphism on the response to lipid-lowering treatment with atorvastatin or fenofibrate. J. Cardiovasc. Pharmacol. Ther. 2006; 11: 211–21. DOI: 10.1177/1074248406293732
-
Trompson J.F., Hyde C.L., Wood L.S., Paciga S.A., Hinds D.A., Cox D.R. et al. Comprehensive wholegenome and candidate gene analysis for response to statin therapy in the Treating to New Targets (TNT) cohort. Circ. Cardiovasc. Genet. 2009; 2: 173–81. DOI: 10.1161/CIRCGENETICS.108.818062
-
Petrovic D., Peterlin B. Genetic markers of restenosis after coronary angioplasty and after stent implantation. Med. Sci. Monit. 2005; 11 (4): 127–35.
-
Wang Sh., Dai Y., Chen L., Dong Z., Chen Y., Li C. et al. Genetic polymorphism of angiotensin converting enzyme and risk of coronary restenosis after percutaneous transluminal coronary angioplasties: evidence from 33 cohort studies. PLoS One. 2013; 8 (9): 1–6. DOI: 10.1371/journal.pone.0075285
-
Pan Y., Wang F., Qiu Q., Ding R., Zhao B., Zhou H. Influence of the angiotensin converting enzyme insertion or deletion genetic variant and coronary restenosis risk: evidence based on 11,193 subjects. PLoS One. 2013; 13 (12): e83415. DOI: 10.1371/journal.pone. 0083415
- Zhu M., Yang M., Lin J., Zhu H., Lu Y., Wang B. et al. Association of seven renin angiotensin system gene polymorphisms with restenosis in patients following coronary stenting. J. Renin AngiotensinAldosterone Syst. 2017; 18 (1). DOI: 10.1177/1470320316688774
About the authors
- Yuriy I. Buziashvili, Dr. Med. Sc., Professor, Academician of the Russian Academy of Sciences, Head of Clinical Diagnostic Department
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Inna V. Koksheneva, Dr. Med. Sc., Senior Researcher; orcid.org/0000-0002-8797-9340
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Karen V. Petrosyan, Cand. Med. Sc., Head of Department of X-ray-Surgical Methods for the Study and Treatment of the Heart and Blood Vessels; orcid.org/0000-0002-3370-0295
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Maya A. Kakauridze, Postgraduate
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Il'ya A. Inauri, Cardiologist
