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The results of several studies which have been published since 1992 evidence a significant correlation between DD genotype of angiotensin 1-converting enzyme (ACE) gene and development of coronary artery disease (CAD) in some populations. The authors of this article studied distribution of ACE gene I/D genotypes (II, ID, DD) in 102 patients with CAD and 50 controls without cardiovascular pathology or diabetes mellitus. The CAD diagnosis was confirmed by coronaroangiography. The study established a significant correlation between the presence of DD-ACE genotype and development of CAD. After exclusion of patients with classic risk factors (body mass index greater than 26 kg/m2; arterial hypertension; dislipidemia), this correlation remained. The results of the study demonstrate a significant positive correlation between the presence of DD genotype and high risk of CAD in this population, including people without such classic risk factors as obesity, arterial hypertension, or dislipidemia.

The stent was placed in 528 coronary artery segments (39% complicated lesions) in 448 patients with coronary artery disease and no previous invasive interventions. Immediate angiographic success was 99.8% with no case of acute thrombosis. Six months survival without restenosis, angina, and reintervention was 83%. Repeat angiography was carried out in 432 patients with 502 stented stenoses. Index of vessel diameter loss and level of restenosis were 0.32+/-0.26, and 15,6%, respectively. Fifty four patients with in-stent restenosis were subjected to successful repeat revascularization. Eighteen months survival without myocardial infarction and reintervention was 70%. The study demonstrated favorable effect of TAIS on 18 month rate of thrombosis and restenosis in patients with native atherosclerotic lesions.

Aim: To evaluate two-year results of using a metallic stent EPHESOS in patients with native atherosclerotic lesion of coronary arteries (without prior interventions)., Material and Methods: The stent was implanted to 731 patients. 53% had manifestations of unstable angina. 42% of the lesions were complicated. The length of the stenosis was 15.5 +/- 6.8 mm, 44% stenoses were long., Results: The success of stenting was 99.6%. Cases of acute and subacute thrombosis were absent. Non-Q wave myocardial infarction in primary hospitalization developed in 4 patients. For 6 months, cardiovascular complications (death, angina, restenosis, repeated revascularization) occurred in 21%. Angiographic control follow-up of 6 months maximum covered 329 (45%) patients. Hemodynamically significant restenosis was detected in 18% patients. Cardiovascular complications for 24 months occurred in 39%., Conclusion: The EPHESOS stent has demonstrated a stable long-term effect on prevention of thrombosis and restenosis in the majority of patients with a relatively high risk of intervention.

Aim: An open non-randomized trial was initiated to assess clinical and angiographic results of using the coronary stent "Ephesos" in 457 patients with stable or unstable angina pectoris and native coronary affections., Material and Methods: 268 stents have been implanted in 231 patients with stable angina (SA) and 271 stents--in 226 patients with unstable angina (UA). 46% lesions were complicated. The length of stenosis was 12.9 +/- 6.7 mm in the group SA and 14.1 +/- 7.4 mm in the group UA, 30% stenoses were long., Results: Successful stenting was stated in 99% without cases of acute thrombosis. Non-fatal myocardial infarction took place in hospital in 1.3% of SA patients and in 2.6% of UA patients. Incidence of cardiac complications (death, recurrent angina pectoris, myocardial infarction, restenosis, repeated revascularization) for 6-month follow-up was 15.6% in SA group and 18.1% in UA group. At angiographic control, the index of vascular diameter loss made up 0.22 +/- 0.2 in SA group and 0.3 +/- 0.27 in UA group. Incidence of restenosis was 12 and 14%, respectively. 18-month follow-up found no differences in frequency of complications: 21.6 and 22.6% in groups SA and UA, respectively., Conclusion: Implantation of the stent "Ephesos" is effective in prevention of thrombosis and restenosis in patients with stable or unstable angina pectoris at high risk of intervention.

In-stent restenosis (ISR), when treated with balloon angioplasty (PTCA) alone, has an angiographic recurrence rate of 30-85%. Ablating the hypertrophic neointimal tissue prior to PTCA is an attractive alternative, however late outcomes of such treatment have not been fully determined. This multicenter case control study assessed angiographic and clinical outcomes of 137 consecutive procedures in 125 patients treated for ISR with either PTCA alone (n = 58) or excimer laser assisted coronary angioplasty (ELCA, n = 67). Demographics were similar. Lesions selected for ELCA compared with those selected for \PTCA were longer (17.1+/-9.9 mm vs. 13.6+/-9.1 mm; p=0,034), more complex (ACC/AHA type C: 36,5% vs. 14,3%; p=0,006), and with reduced antegrade flow (TIMI flow < 3: 18,9% vs. 4,8%; p = 0,025). ELCA- and PTCA treated patients had similar rates of procedural success (98,5 and 98,3%, respectively, p=1,0), major clinical complications (3,0% and 8,6%; respectively, NS), major cardiac events at 1 year (37,3 and 46,6%. respectively, NS), and target lesion revascularization (32,8 and. 34,5%; respectively, NS). These data suggest that ELCA in patients with complex in-stent restenosis is as safe and effective as PTCA. Despite higher lesion complexity in ELCA-treated patients, no increase in event rates was observed.

Background: The serum of patients with coronary atherosclerosis contains circulating immune complexes including low-density lipoproteins (LDLs). We have developed a technique for the evaluation of LDL content in circulating immune complexes by measuring total cholesterol levels in polyethylene glycol precipitates (immune cholesterol). In the present study, the value of immune cholesterol in the diagnosis of atherosclerosis was compared with that of other laboratory parameters, such as total cholesterol levels, triglycerides, LDL cholesterol, high-density lipoprotein cholesterol, lipoprotein(a), and apolipoproteins B and A-1., Methods: Immune cholesterol and the other parameters were determined in blood samples from 200 patients with documented coronary and extracoronary atherosclerosis. Coronary atherosclerosis was assessed by coronary angiography; stenoses in the aortic arch and branches and in lower-limb arteries were evaluated by angiography and ultrasonography., Results: Only immune cholesterol and the ratio of apolipoprotein B to apolipoprotein A-1 correlated significantly with the severity of coronary atherosclerosis. The accuracy of the diagnosis of coronary atherosclerosis by immune cholesterol was 78%, considerably higher than that of other laboratory parameters. Use of a combined parameter consisting of immune cholesterol, LDL cholesterol, and the patient's age increased the diagnostic accuracy to 81%. A high level of immune cholesterol is characteristic not only of coronary atherosclerosis but also of extracoronary atherosclerosis. The sensitivity, specificity and accuracy of the diagnosis of extracoronary atherosclerosis were even higher than those for coronary atherosclerosis., Conclusion: Immune cholesterol may be employed as a novel marker in the diagnosis of advanced atherosclerosis.

The total lipid content of white blood cells from healthy donors and patients with angiographically documented atherosclerosis of coronary arteries (CHD patients) was determined by flow cytofluorometry. The cells of donors were homogeneous with respect to intracellular lipid level. However, two subpopulations of white blood cells were identified in CHD patients based on their lipid content. The first population was identical to cells of donors with regard to lipid content, whereas cells of the second subpopulation (10 to 60% of the total cell number) had a four- to eightfold greater amount of intracellular lipid. The main classes of lipids accumulated in these cells were triglycerides and cholesteryl esters. It is postulated that the occurrence of lipid-laden cells in the blood may be used as an indicator of the presence of atherosclerotic lesions in human coronary arteries.

The study was undertaken to examine 134 patients who were divided into 2 groups: 1) those with angiographically documented coronary atherosclerosis and 2) those with unaltered coronary arteries. The levels of immune complex cholesterol and the parameters of serum lipid spectrum were investigated in all the patients. The level of immune complex cholesterol and the apo B/apo AI ratio were the most informative indices in the characterization of coronary atherosclerosis. Immune complex cholesterol may be used as a marker of coronary atherosclerosis, the diagnostic accuracy is 78% with this method.

As many as 107 patients with coronary atherosclerosis, 66 with peripheral atherosclerosis, 27 with unaltered coronary arteries and 30 healthy blood donors were examined. The content of cholesterol in immune complexes was significantly higher in patients with coronary and peripheral atherosclerosis as compared to patients with intact arteries and healthy subjects. The highest content of cholesterol in immune complexes was detected in patients with combined lesions of coronary arteries and arteries of the lower limbs. It exceeded 3.5-5.5-fold the content of cholesterol in immune complexes in the control groups. The accuracy of the diagnosis with the aid of measuring the content of cholesterol in immune complexes in atherosclerosis of any sites was equal to 85%, in peripheral atherosclerosis to 89%, which slightly exceeded the diagnosis accuracy in atherosclerosis of coronary arteries (83%).

Recently we have demonstrated that cholesterol level in LDL-containing circulating immune complexes (CIC cholesterol) correlates with the presence of coronary atherosclerosis. In the present study we attempted to clarify whether CIC cholesterol level correlates with the severity of coronary atherosclerosis. The second task was to reveal the diagnostic value of CIC cholesterol in comparison with other lipid and lipoprotein parameters used as markers of dislipidaemia associated with atherosclerosis. The subjects were 107 patients with angiographically-documented coronary atherosclerosis and 66 patients with documented extracoronary atherosclerosis. Only CIC cholesterol and the apo B/apo A-1 ratio contributed strongly to the discrimination between patients with coronary atherosclerosis and those without stenoses. On the other hand, total cholesterol, triglycerides, HDL cholesterol, apo B, Lp[a] and apo A1 did not correlate with the presence and severity of coronary atherosclerosis. Subjects with stenosis of extracoronary arteries had significantly higher CIC levels than healthy donors. Sensitivity, specificity and accuracy of coronary atherosclerosis diagnosis were assessed for each parameter examined. It was revealed that CIC cholesterol is the most reliable marker of coronary atherosclerosis as compared to other chemical parameters. In addition, the CIC cholesterol level diagnoses extracoronary atherosclerosis with high accuracy.

Ninety three individuals were examined and divided into 3 groups: (1) patients with coronary heart disease in the presence of angiographically documented coronary atherosclerosis; (2) those with non-specific aortoarteritis; and (3) subjects without signs of cardiovascular disease. Blood levels of lipid-saturated mononuclear cells were measured by flow cytofluorimetry. The patients (42 (90%) patients of 46) of the first group were found to have higher blood lipophages than those of the other groups, no correlation being established between the plasma content of total cholesterol, high density lipoprotein cholesterol and triglycerides.

A study was made of the capacity of peritoneal macrophages to demonstrate the atherogenic potential of blood serum. Murine and human macrophages were found to be capable of intracellular accumulation of cholesterol during cultivation with blood sera from patients with coronary atherosclerosis. The data on the capacity to demonstrate blood serum atherogenicity while using peritoneal macrophages do not differ from those obtained previously on the use of smooth muscle cells of the aortal intima and media. The cell culture of the aortal intima and peritoneal macrophages can be used for assessing the atherogenic potential of blood serum.