Svintsitskyi I. Features of coronary atherosclerosis and predictors of its severity in patients with stable ischemic heart disease: sex and age-related aspects

The dissertation proposes improvement of approaches to detection and evaluation of atherosclerotic changes of coronary arteries in patients with stable ischemic heart disease (SIHD) on the basis of complex analysis of clinical, imaging and laboratory examination of patients and taking into account sex and age-related factors. In this study we determined the diagnostic value of lipoprotein (a) and its indices (LTI and MLTI) as markers of obstructive coronary atherosclerosis in patients with SIHD. Sex and age-related differences in the extent of coronary atherosclerosis in patients with SIHD without a history of myocardial infarction, as well as with concomitant type 2 diabetes mellitus were studied. This research also expands the current understanding of the relationship between many lipid parameters (triglycerides, very low density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A1 levels), their indices (Atherogenicity Ratio, Castelli Risk Index I, Atherogenic Index of Plasma, ratio of triglycerides to high density lipoprotein cholesterol, ratio of very low density lipoprotein cholesterol to total cholesterol) and serum uric acid concentration in patients with SIHD. Asymptomatic hyperuricemia has been shown to be an independent predictor of renal dysfunction in patients with chronic coronary syndromes. Scientific data on the relationship between carotid and coronary atherosclerosis were updated. New results were obtained on sex and age-related differences in the association of atherosclerotic changes of the carotid arteries (total number, number of obstructive and nonobstructive carotid stenoses, intima-media thickness) with quantitative parameters of coronary atherosclerosis. The stepwise multiple logistic regression analysis identified independent predictors of obstructive coronary lesions.