rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2019-15-2-159-165rpcardio-1908Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯCardiorenal relationships in the focus of risks of atrial fibrillation in patients after acute ST-elevated myocardial infarction (observational program FAKEL)Кардиоренальные взаимосвязи в фокусе рисков развития фибрилляции предсердий у пациентов после острого инфаркта миокарда с подъемом сегмента ST (результаты исследования ФАКЕЛ)ЗолотовскаяИ. А.ZolotovskayaI. A.

Золотовская Ирина Александровна - кандидат медицинских наук, доцент, кафедра госпитальной терапии с курсами поликлинической терапии и трансфузиологии, СамГМУ.

443099, Самара, ул. Чапаевская, 89

Irina A. Zolotovskaya - MD, PhD, Associate Professor, Chair of Hospital Therapy with a Course in Outpatient Treatment and Transfusion Medicine.

Chapaevskaya ul. 89, Samara, 443099

zolotovskay@lis.ruДавыдкинИ. Л.DavydkinI. L.

Давыдкин Игорь Леонидович - доктор медицинских наук, профессор, заведующий кафедрой госпитальной терапии с курсами поликлинический терапии и трансфузиологии, директор НИИ гематологии, трансфузиологии и интенсивной терапии, СамГМУ.

443099, Самара, ул. Чапаевская, 89

Igor L. Davydkin - MD, PhD, Professor, Head of Chair of Hospital Therapy with a Course in Outpatient Treatment and Transfusion Medicine, Director of Research and Development Institute of Hematology, Transfusion and Intensive Care.

Chapaevskaya ul. 89, Samara, 443099

ДупляковД. В.DuplyakovD. V.

Дупляков Дмитрий Викторович - доктор медицинских наук, профессор, кафедра кардиологии и сердечно-сосудистой хирургии, Институт профессионального образования, СамГМУ.

443099, Самара, ул. Чапаевская, 89

Dmitry V. Duplyakov - MD, PhD, Professor, Chair of Cardiology and Cardiovascular Surgery.

Chapaevskaya ul. 89, Samara, 443099

КокоринВ. А.KokorinV. A.

Кокорин Валентин Александрович - кандидат медицинских наук, доцент, кафедра госпитальной терапии №1, РНИМУ им. Н.И. Пирогова.

117997, Москва, ул. Островитянова, 1

Valentin A. Kokorin - MD, PhD, Associate Professor, Chair of Hospital Therapy No. 1.

Ostrovitianova ul. 1, Moscow, 1 1 7997

Самарский государственный медицинский университетРоссияSamara State Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет им. Н. И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation201904052019152159165Copyright © Zolotovskaya I.A., Davydkin I.L., Duplyakov D.V., Kokorin V.A., 20192019Золотовская И.А., Давыдкин И.Л., Дупляков Д.В., Кокорин В.А.Zolotovskaya I.A., Davydkin I.L., Duplyakov D.V., Kokorin V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1908Aim

Aim. To study markers of renal dysfunction in relation to the likelihood of atrial fibrillation (AF) in patients after ST-segment elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

Material and methods

Material and methods. The study was conducted with the inclusion of 1 52 patients discharged for outpatient monitoring after STEMI. There were 4 visits: V1 - inclusion visit, V2 - in 12 months, V3 - in 18 months, V4- in 24 months with determination of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP), cystatin C, erythropoietin, galectin-3, von Willebrand factor (fW), left ventricular ejection fraction. Endpoint: new cases of AF, cardioembolic stroke, deaths.

Results

Results. After 24 months 35 patients (23.0%) were diagnosed with AF, 6 of them (3.9%) - developed cardioembolic stroke. The multivariate model of risk factors for AF included indicators: cystatin C (odds ratio [OR] 1.31; 95% confidence interval [95%CI] 1.03-1.67), NT-ProBNP (OR 1.11; 95%CI 1.03-1.19), galectin-3 (OR 0.71; 95%CI 0.55-0.91), fV (OR 0.71; 95%CI 0.55-0.91).

Conclusion

Conclusion. The prognostic significance of cystatin C in relation to the risk of AF was established, which should be considered when assessing the prognosis in patients after STEMI.

Цель

Цель. Изучить маркеры почечной дисфункции во взаимосвязи с вероятностью развития фибрилляции предсердий (ФП) у пациентов после инфаркта миокарда с подъемом сегмента ST (ИМпБЛ, перенесших первичное чрескожное коронарное вмешательство (ЧКВ).

Материал и методы

Материал и методы. Исследование проведено с включением 152 пациентов, выписанных на амбулаторный этап наблюдения после ИМпST Проведено 4 визита (V): V1 - визит включения, V2 - через 1 2 мес, V3 - через 1 8 мес, V4 - через 24 мес с определением показателей плазменной концентрации N-концевого пропептида мозгового натрийуретического гормона (NT-proBNP), цистатина С, эритропоэтина, га-лектина-3, фактора Виллебранда (фВ), фракции выброса левого желудочка (ФВ ЛЖ). Конечные точки: развитие ФП, кардиоэмболический инсульт (КЭИ), смертельные исходы.

Результаты

Результаты. Через 24 мес у 35 больных (23%) диагностирована ФП, из них у 6 (3,9%) развился КЭИ. В многомерную модель факторов риска развития ФП вошли показатели: цистатин С (отношение шансов [ОШ] 1,31; 95% доверительный интервал [95%ДИ] 1,03-1,67), NT-ProBNP (ОШ 1,11; 95%ДИ 1,03-1,19), галектин-3 (ОШ 0,71; 95%ДИ 0,55-0,91), фВ (ОШ 0,71; 95%ДИ 0,55-0,91).

Заключение

Заключение. Выявлена прогностическая значимость цистатина С в отношении риска развития ФП, что следует учитывать при оценке прогноза у больных после ИМпSI.

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The authors declare that there are no conflicts of interest present.