Khomych A. Improvement of diagnostic of obstructive coronary atherosclerosis and segment left ventricular systolic function estimation after coronary artery stenting

In the work, based on the analysis of the results of the 5-year follow-up after coronary artery stenting, the most important risk factors of adverse events were investigated: incomplete revascularization, stenosis type C of primary lesion, stable angina class III-IV prior to revascularization, non-effective hypolipidemic therapy. These patients require active management and high-intensive statin therapy after coronary artery stenting to improve outcomes. A new non-invasive method for the determination of coronary obstructive atherosclerosis – the index of coronary obstruction (INCO) is completely proposed in the wider clinical practice. INCO was expressed in conventional units and calculated as the ratio of CAD pretest probability to mean systolic wall motion velocity of 12 myocardial segments measured by tissue doppler imaging. High INCO sensitivity and specificity at value - 8 units to determine obstructive lesions in coronary arteries were shown. INCO calculation is cheap and can be widely used at the first steps of non-invasive diagnostics in suspected CAD as well as for determination of the further strategy in patients after coronary revascularization. It is also suitable for monitoring patients with coronary heart disease who do not have evidence for immediate revascularization for timely non-invasive determination of such needs during further follow-up.