ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2019, 4(5): 102–108
https://doi.org/10.26693/jmbs04.05.102
Clinical Medicine

Endothelial Dysfunction and Ways of its Prevention during Percutaneous Coronary Interventions by Recanalization of Coronary Arteries

Aksenov E. V.
Abstract

The work presents the study of endothelial dysfunction and its prophylaxis during percutaneous coronary interventions in patients with coronary artery disease. The purpose of this work was to investigate the level of markers of endothelial dysfunction and its methods of prevention in radiographic and vascular coronary angioplasty and stenting in patients with coronary artery disease. Material and methods. The study included 120 people who did not have gender differences. These people underwent percutaneous transluminal coronary angioplasty and stenting for stable or unstable angina in the department оf X-ray-surgical methods of diagnostic and treatment of heart and vascular diseases of the Amosov National Institute of Cardiovascular Surgery National Academy of Medical Sciences of Ukraine. The age of the examined was 66.96±1.81 years, average weight was 86.5±1.44 (from 67 to 102 kg). They had no statistically significant differences of the level of coronary arteries disease, the degree of angina pectoris and the type of performed diagnostic or treatment interventions (p> 0.05). The frequency of the apparent mortification of pathologies was unchanged in both groups (p> 0.1). Results and discussion. All patients were divided into two groups: the first group included 42 patients who had a modified method of prevention and treatment of endothelial dysfunction was used, and the second (control group) had 78 patients who used routine therapy. The modified method used for the patients of group I, included the following provisions: administration of rosuvastatin at a dose of 10 mg per day for 12 weeks to patients, administration of L-arginine at a dose of 7 g 3 times a day for 4 weeks, prescription of vitamin C infusion at a dose of 3 g per hour before the endovascular procedure. In addition to routine recording of the clinical status of patients, the target examination included the determination of the functional state of the endothelium (level of nitrates in plasma and erythrocytes, L-arginine concentration, the number of desquamated endotheliocytes in the blood plasma). Conclusion. The findings showed that endothelial dysfunction plays a significant role in the development of coronary complications of endovascular diagnostic and treatment interventions (spasm, thrombosis and coronary artery restenosis), and interventional interventions in such a cohort of patients is associated with a higher risk of coronary complications. The use of a modified method of prevention and treatment of endothelial dysfunction contributed to the restoration of the functional state of the endothelium and an increase in endothelium-dependent vasodilation and dilatation on the introduction of nitrates.

Keywords: endothelial dysfunction, recanalization, coronary artery

Full text: PDF (Ukr) 340K

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