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Metelskaya V.A.
National Medical Research Center for Therapy and Preventive Medicine
Zhatkina M.V.
National Medical Research Center for Therapy and Preventive Medicine
Gavrilova N.E.
National Medical Research Center for Therapy and Preventive Medicine
Bogdanova N.L.
National Medical Research Center for Therapy and Preventive Medicine
Litinskaya O.A.
National Medical Research Center for Therapy and Preventive Medicine
Pokrovskaya M.S.
National Medical Research Center for Therapy and Preventive Medicine
Drapkina O.M.
National Medical Research Center for Therapy and Preventive Medicine;
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Validation of combined markers of the presence and severity of coronary atherosclerosis
Journal: Russian Journal of Preventive Medicine. 2020;23(6): 94‑100
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To cite this article:
Metelskaya VA, Zhatkina MV, Gavrilova NE, et al. . Validation of combined markers of the presence and severity of coronary atherosclerosis. Russian Journal of Preventive Medicine.
2020;23(6):94‑100. (In Russ.)
https://doi.org/10.17116/profmed20202306194
To validate the previously proposed combined biomarkers, developed to assess the likelihood and severity of coronary atherosclerosis in an independent cohort of patients examined to original one in similar way.
The validity of the previously formed biomarkers was checked on an independent cohort of 216 patients examined in the hospital, who underwent coronary angiography and duplex scanning of the carotid arteries (CA) for diagnostic purposes.
If a patient has all three indicators that make up a combined biomarker (male gender, CA stenosis more than 45%, adiponectin level less than 8.0 μg/ml), the probability of coronary atherosclerosis (Gensini scale, GS>0) increases by 7.81 times: OR 7.81 (95% CI 1.00-61.36). The high risk of severe coronary atherosclerosis (GS≥35) in individuals from the new cohort is evidenced by a combination of intima media thickness of more than 0.9 mm in a patient of either sex, a high-sensitivity C-reactive protein level of 3.0 mg/L and above, and a reduced level adiponectin (less than 8.0 μg/ml). If the patient has all three indicators, the probability of having severe coronary atherosclerosis is 3.23 times higher: OR 3.23 (95% CI 1.35-7.74). Both markers are characterized by a rather low sensitivity: 9.9% for the diagnosis of any atherosclerotic lesion and 19.4% for severe atherosclerosis, which is compensated by their high specificity: 98.6% and 93.1%, respectively, which makes it possible to exclude from the increased/high risk group persons without any or severe lesions of the coronary arteries.
Based on the analysis of a wide range of instrumental and biochemical parameters on an independent cohort of patients, the previously proposed complex (combined) markers of the presence and severity of coronary atherosclerosis were tested; substantiated the suitability of using these complexes of non-invasive markers to identify patients with no atherosclerosis of the coronary arteries of any degree and/or without pronounced atherosclerotic lesions, for whom coronary angiography is probably inappropriate.
Authors:
Metelskaya V.A.
National Medical Research Center for Therapy and Preventive Medicine
Zhatkina M.V.
National Medical Research Center for Therapy and Preventive Medicine
Gavrilova N.E.
National Medical Research Center for Therapy and Preventive Medicine
Bogdanova N.L.
National Medical Research Center for Therapy and Preventive Medicine
Litinskaya O.A.
National Medical Research Center for Therapy and Preventive Medicine
Pokrovskaya M.S.
National Medical Research Center for Therapy and Preventive Medicine
Drapkina O.M.
National Medical Research Center for Therapy and Preventive Medicine;
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Received:
27.04.2020
Accepted:
03.09.2020
List of references:
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