Статья
Прогностическая значимость динамики содержания высокочувствительного С-реактивного белка в крови после планового коронарного стентирования в отношении развития рестеноза стента
Цель Проанализировать взаимосвязи между содержанием высокочувствительного С-реактивного белка (вч-СРБ) в сыворотке крови в динамике и развитием рестеноза через 12 мес после планового коронарного стентирования (КС).Материал и методы Ключевая роль в процессе атерогенеза, пролиферации неоинтимы и рестеноза принадлежит воспалению. В исследование был включен 91 пациент (медиана возраста 60 [56; 66] лет) со стабильной стенокардией напряжения с выполненным плановым КС с использованием стентов II поколения. Контрольная коронарография через 12 мес была проведена 60 больным. Содержание вч-СРБ оценивалось непосредственно перед КС, через 1, 3, 6 и 12 мес после КС. У 8 пациентов наблюдался рестеноз стентированного сегмента (50 % или большей выраженности сужение стентированного сегмента либо участка сосуда, на протяжении 5 миллиметров проксимально или дистально прилегающего к стентированному сегменту).Результаты По данным ROC-анализа, наибольшей прогностической значимостью в отношении рестеноза обладало увеличение концентрации вч-СРБ ≥0,9 мг / л (≥25 %) через 1 мес после КС (площадь под ROC-кривой 0,89 при 95 % доверительном интервале – ДИ от 0,79 до 0,99), чувствительность 87,5 %, специфичность 82,8 %; р=0,0005), которому уступало абсолютное значение концентрации вч-СРБ >3,0 мг / л (площадь под ROC-кривой 0,82 при 95 % ДИ от 0,68 до 0,96; р=0,0007).Заключение Увеличение концентрации вч-СРБ ≥0,9 мг / л (≥25 %) через 1 мес после КС ассоциируется с рестенозом стентированного сегмента коронарной артерии.
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