According to experts, multifaceted pathogenic mechanisms underlying the development and progression of metabolic syndrome (MS) have a significant impact on quality of life and prognosis of patients with acute and chronic forms of coronary artery disease (СAD), including cases of percutaneous coronary intervention (PCI) and open the way to search for specific approaches to treatment. The aim of the research was to increase the efficiency of complex treatment of the patients with CAD and MS who underwent PCI for acute coronary syndrome without ST-segment elevation (ACS non ST) by creating of personified approach to cardiocytoprotective therapy during inpatient and outpatient stages with pathogenetic substantiation of negative factors for cardiovascular prognosis. Methods: general clinical (medical history, analysis of complaints, data of questionnaires, physical examination), laboratory (enzyme calorimetry, polymerase chain reaction, enzyme immunosorbent assay), instrumental (electrocardiography (ECG), and ambulatory ECG monitoring, echocardiography, stress-test veloergometry (VEM), coronary angiography), methods of statistical and mathematical analysis of the data. During the selection phase 150 patients with CAD and MS were selected. 99 patients (men - 69,7 %, women - 30,3 %) age (67,4 ± 0,7)years, that meet the criteria for inclusion / exclusion constituted the main group of thesis. The control group included 51 patients age (64,6 ± 1,3) years with MS according to data of history, anthropometric and laboratory criteria and the results of CAD according to coronary angiography, but without the presence ACS non ST and data about previous myocardial infarction or stroke. The main and the control groups of thesis were comparable in age (p=0.06) and sex (?2 =0.14, p> 0.05). It was conducted genotype evaluation of 150 patients of main and control groups to identify features in occurrence of guanine nucleotide binding protein beta polypeptide 3 (GN?3) C825T polymorphism; endothelial nitric oxide synthase (eNOS) T786C and G894T gene polymorphisms in Ukrainian population of Odessa region among patients with MS after ACS non ST. So, ACS non ST recorded much less in patients with GN?3 825 CC genotype and eNOS 894 GT genotype (p<0.05). ACS non ST recorded much more in patients with GN?3 825 CT genotype, eNOS 786 CC genotype and eNOS 894 GG (p<0.05). Forecast-negative genotypes with respect to the cumulative occurrence of terms of adverse events (cardiovascular death, recurrent case of ACS, restenosis / stent thrombosis, second case of revascularization, decompensation of chronic heart failure) during (18,4 ± 0,2) months are: GN?3 825 ТТ genotype, еNOS 786 CC and еNOS 894 TT genotypes. The same way, the thesis was carried out theoretical generalization and set out a new solution to date scientific and practical cardiology problem, namely the identification of the genetic preconditions for occurrence of ACS without persistent ST segment elevation in patients with CAD and MS, the definition of the clinical manifestations of the disease within 12 months after PCI, a prospective analysis of clinical, laboratory and instrumental data of patients, depending on the purpose and variants of cardiocytoprotective therapy with trimetazidine or quercetin, statistical calculation of predictors of cardiovascular events based on clinical data and genetic determinants.
