The High-Grade Oxidative Profile (OXpr), Aortic Stiffness Parameters, and Hemogram-Derived Indices (HDI) as Predictors of Long-Term Major Adverse Cardiovascular Events (MACEs) Following Percutaneous Coronary Intervention (PCI) in Patients with Non-ST-Elevation Acute Coronary Syndrome (NSTE-ACS) and Chronic Coronary Syndrome (CCS)

Abstract

BACKGROUND.Despite the achievements in the management of coronary heart disease (CHD), there is a need to appropriately tailor the long-term management strategies and risk stratification, particularly after percutaneous coronary intervention (PCI) because of non-ST-elevation acute coronary syndrome (NSTE-ACS) or chronic coronary syndrome (CCS). OBJECTIVES The Present study aimed to (i) evaluate the long-term cardiovascular prognostic value of oxidative stress markers, arterial stiffness parameters, and hemogram-derived inflammatory indices, and (ii) compare the long-term predictive performance of the above-mentioned markers with the periprocedural SYNTAX score II (SS-II) in Georgian patients following PCI. METHODS After PCI because of NSTE-ACS or CCS, the annual incidence of 6-component MACEs, and values of the oxidative profile, arterial stiffness measurements, and hemogram-derived indices (HDI) were measured during the 36-month follow-up period in the development (100 patients with NSTE-ACS) and validation cohorts (91 patients with CCS), respectively. RESULTS By the multiple regression analysis NLR (0.505±0.069, p<0.0001), OXpr (0.181±0.076, p=0.018), SBPao (0.174±0.076, p=0.023), and PLR (0.164±0.056, p=0.004) are positively correlated with 36-month MACEs. CONCLUSIONS The oxidative stress profile, central systolic blood pressure, and hemogram-derived indices such as neutrophil-lymphocyte and monocytelymphocyte ratios may be used as novel independent predictors of long-term major adverse cardiovascular events. KEYWORDS Central systolic blood pressure (SBPao); chronic coronary syndrome (CCS); major adverse cardiovascular events (MACEs); neutrophil-tolymphocyte ratio (NLR); non-ST-elevation acute coronary syndrome (NSTE-ACS); oxidative profile (OXpr); platelet-to-lymphocyte ratio (PLR). BACKGROUNDespite the latest achievements in the management of coronary heart disease (CHD), there is a residual risk of subsequent major cardiovascular events (MACEs). 1 The risk of future dramatic events is highly heterogeneous, and patients may differ in the degree of benefit received from existing treatment. 2-4 Therefore, there is a need to appropriately tailor the long-term management strategies and risk stratification in patients after percutaneous coronary intervention (PCI) because of non-ST-elevation acute coronary syndrome (NSTE-ACS) or chronic coronary syndrome (CCS).A recent index, the SYNTAX score II (SS-II) is the most potent tool to predict a long-term major cardiovascular event in patients undergoing coronary revascularization. 5-8 However, this predictive index never has been validated in a Georgian acute coronary syndrome (ACS) patient.The accumulated evidence of the recent decades provides deeper insights into the pathophysiology of cardiovascular diseases and accentuates the prognostic significance of new markers related to arterial stiffness, oxidative stress, and lowgrade systemic inflammation.