Highlights. The frequency of long-term fatal cardiovascular complications in patients with chronic coronary syndrome subjected to selective (non-emergency) percutaneous coronary interventions was estimated.Risk stratification model of long-term fatal cardiovascular complications in patients with chronic coronary syndrome subjected to selective percutaneous coronary interventions has been created.Aim. To determine the frequency of long-term fatal cardiovascular events (CVE) after elective percutaneous coronary interventions (PCI) and to develop a model for stratifying the risk of these events.Methods. 150 patients with chronic coronary syndrome and indications for endovascular myocardial  revascularization  were  included  in  the  research.  After  PCI  the patients were observed on an outpatient basis for year. The frequency of fatal cardiovascular complications was estimated by telephone interview 6 years after the index intervention.Results. Survival in the study group after 6 years was 86.1%. Fatal CVEs were reported in 10.6% of patients. The following baseline variables were significant predictors of cardiovascular death included in the individual risk assessment model: NYHA functional class of chronic heart failure (odds ratio (OR) 0.06, 95% confidence interval (CI) 0.003-1.106), lean plasma glucose level (OR 0.07, 95% CI 0.12-0.43), atrial fibrillation (OR 43.1, 95% CI 2.01–922.01), as well as the value of creatinine in the blood one year after the intervention (OR 1.14, 95% CI 1.0–1.3) and glomerular filtration rate (CKD-EPI) (OR 1.4, 95% CI 1.09–1.81). The area under the curve (AUC) of the developed model was 0.976 [95% CI 0,000–1,000].Conclusion. The proposed risk stratification model of developing long-term fatal cardiovascular complications in patients with chronic coronary syndrome subjected to selective (non-emergency) PCI allows identifying patients with an unfavorable long-term (six-year) prognosis.

Aim. To reveal the association of the INS/DEL polymorphism of the angiotensinconverting enzyme (ACE) gene with acute and long-term complications of elective percutaneous coronary interventions (PCI).Material and methods. This prospective study included 286 patients with chronic coronary artery disease who underwent elective endovascular myocardial revascularization in accordance with current guidelines. The ACE gene INS/DEL (I/D) polymorphism was determined in patients using polymerase chain reaction. Acute periprocedural complications were recorded. Acute myocardial injury (AMI) was detected in 30,4% of patients. Type 4a acute myocardial infarction developed in 3,1% of patients. A significant decrease in the glomerular filtration rate by more than 30% due to periprocedural acute kidney injury (AKI) was diagnosed in 6,5% of patients. Outcomes of elective PCIs were assessed after 4 years via telephone interviews. Cardiovascular and any-cause mortality was 3,6% and 5,1%, respectively. Acute coronary syndrome during the follow-up period developed in 15,2%, while cerebrovascular accident — in 5,4% of patients. Any-stent thrombosis was detected in 10%, and restenosis ≥30% — in 21,8% of patients. Statistical analysis was carried out using the STATISTICA 10. The odds ratio (OR) was calculated with a 95% confidence interval.Results. Analysis of the association of ACE gene I/D polymorphism with acute and long-term complications of the PCI revealed that the presence of I allele is associated with the risk of periprocedural AKI (p=0,017; OR, 2,627 (1,161- 5,947)), as well as long-term cardiovascular events, vascular complications such as acute coronary syndrome (p=0,045; OR, 1,610 (1,007-2,573)) and stent thrombosis (p=0,01; OR, 2,073 (1,178-3,650)). The presence of genotype II further increases the risk of AKI (p=0,029; OR, 5,138 (1,022-25,824)), any acute clinical complications of PCI (p=0,041; OR, 1,996 (1,024-3,980)), and stent thrombosis (p=0,018, OR, 3,498 (1,178-10,392)).Conclusion. In patients with chronic coronary artery disease, the carriage of allele I and genotype II of the ACE gene I/D polymorphism is associated with the risk of acute clinical complications of elective PCI, periprocedural AKI, as well as the risk of stent thrombosis and acute coronary syndrome within 4-year follow-up period after PCI.

Aim. To determine the differences in self-assessment of social functioning by patients with chronic coronary artery disease (CAD), depending on the presence of comorbid affective disorders (ADs).Materials and methods. Using the Social Adaptation Self-Evaluation Scale (SASS), which makes it possible to assess the degree of social functioning and satisfaction with various aspects of social life, we studied the features of the social functioning of heart hospital patients with chronic CAD with (n = 248) and without AD (n = 291). In 290 patients (average age 56.6 ± 6.7 years) with chronic CAD, chronic ADs (45%) were revealed; depressive episodes (DEs) were diagnosed for the first time in 24% of patients, and 24.5% of patients had recurrent DEs. Bipolar disorder was found in 6.5% of cases. Qualitative and quantitative parameters were investigated using the Mann – Whitney U test and Student’s t-test. To assess the frequencies, the Pearson’s chi-squared test was used.Results. The mean total SASS score in the patients with chronic CAD with AD corresponded to difficult social adaptation (33.7 [29.5; 39]), while the patients without AD had good social adaptation score of 40.8 ± 6.3 (p < 0.05). In the group without AD, patients with normal social adaptation prevailed (n = 215; 73.8%), while patients with AD more often had difficulties with social adaptation (n = 148; 59.7%). In the CAD patients, depending on the presence of AD, the frequency of disturbances in various spheres of social adaptation differed: employment, interest in and pleasure from activities, disposition of income, pleasure from and interest in seeking information, social support (p = 0.001).Conclusion. Higher frequency of pronounced impairment in social functioning in patients with chronic CAD with AD determines the need for taking this fact into consideration when planning rehabilitation measures in this group of patients.