[Clinical and prognostic significance of free radical processes in patients with coronary heart disease].

The aim of the work was to evaluate the diagnostic and prognostic value of the characteristics of processes involving free radicals and of high-performance ECG (hpECG) in patients with coronary heart disease (CHD). A new method for early assessment of the severity of myocardial ischemia and its electric remodelling was developed. Malonic dialdehyde levels (MDA) following Cu-induced oxidation during 24 hr were shown to correlate with clinical features of CHD (functional class of angina, hpECG patterns). hpECG characteristics changed parallel to MDA levels, their frequency was related to the severity of CHD. Long-term prognosis of unstable angina (12 month follow-up) was aggravated in patients with MDA level of 100 nmol/ml. MDA concentration and its dynamics correlated with CHD severity and outcome of acute coronary syndrome (ACS): non-Q wave myocardial infarction and angina. All patients with ACS underwent its exacerbation within 5-7 days and had depleted plasma antioxidative system. MDA and hpECG dynamics can be used to evaluate ACS severity and prognosis as a new diagnostic approach to identifying CHD patients with the expected unfavourable outcome of the disease.