RENAL FUNCTION MARKERS FOR LONG-TERM CARDIOVASCULAR PREDICTION IN INDIVIDUALS AFTER MYOCARDIAL REVASCULARIZATION

Goal - assessment of the renal dysfunction impact on the probability of cardiovascular complications development in the long-term period after myocardial revascularization. 90 patients with ischemic heart disease (IHD) and myocardial revascularization indications were involved in the study. All the patients underwent coronary angiography (CAG), by determining the method of myocardial revascularization (MR) - coronary artery bypass grafting or coronary artery stenting. Traditional risk factors and renal dysfunction markers (albuminuria in the range of 30-300 mg/L, β2-microglobulinuria) were revealed in all the patients examined. Renal risk factors were examined twice - before myocardial revascularization and 6.3±0.1 months after it. According to CAG results, the endophytic growth rate of atheromatous plaque was determined by the calculation method. Death or need for repeated myocardial revascularization in 5.8±0.05 years was considered the endpoint of the study. Of the 81 patients who continued to participate in the study, 10 patients died (12.3%), 4 patients underwent MR (4.9%). Statistical analysis of the data showed that increase in Al semi-quantitative value (χ-test - 4.25; p=0.04) has a significant effect on the probability of reaching the endpoint of the study. A significant effect on the studied prognosis of β2-microglobulin (β2-MG) (>0.05) could not be established. However, a direct linear relationship between β2-MG value in urine and VEG AB (r=0.41, p=0.0008) was established. Among all the traditional risk factors studied, a significant impact of the left ventricle myocardial hypertrophy indicators on the death risk or repeated MR [thickness of interventricular septum (χ-test - 4.03; p=0.04) and left ventricular posterior wall (χ-test - 7 49; p=0.006)] was established. According to the results of the study, implementation of the cardiorenal syndrome in the form of a predictive Al value and β2-MG determination in urine, was shown. An increased urinary albumin excretion in dynamics is a cardiovascular risk marker in the long-term period after MR. β2-MG indicator has a direct linear relationship with the atherosclerosis progression rate. Among all the traditional risk factors, the left ventricular hypertrophy indicators have a particular importance.