Diagnosis of the increased thrombotic risk in patients with chronic coronary syndrome after percutaneous coronary intervention: focus on the immune and fibrinolytic systems
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1 Russian University of Medicine, Moscow, Russian Federation
2 Davydovskiy City Clinical Hospital, Moscow, Russian Federation
3 Emanuel Institute of Biochemical Physics, Russian Academy of Science, Moscow, Russian Federation
4 Skolkovo Institute of Science and Technology, Moscow, Russian Federation
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Type: Original articles
DOI:
For citation: Anisimova A.S., Rusakovich G.I., Maryukhnich E.V., Ivanova O.I., Kordzaya E.L., Elizarova A.K., Kononikhin A.S., Bugrova A.E., Zakharova N.V., Nikolaev E.N., Vasilieva E.Yu. Diagnosis of the increased thrombotic risk in patients with chronic coronary syndrome after percutaneous coronary intervention: focus on the immune and fibrinolytic systems. Creative Cardiology. 2026; 20 (1): 115–127 (in Russ.). DOI: 10.24022/1997-3187-2026-20-1-115-127
Received / Accepted: 12.01.2026 / 03.03.2026
Keywords: chronic coronary syndrome antiplatelet therapy ischemic events immunothrombosis proteomic analysis
Abstract
Objective. To identify factors associated with increased risk of thrombotic complications in patients with chronic coronary syndrome (CCS) after percutaneous coronary intervention (PCI).
Material and methods. We enrolled 72 CCS patients after PCI receiving dual antiplatelet therapy (DAPT). All the patients underwent platelet aggregation assessment by impedance aggregometry and plasma proteomic profiling at admission and on 3–5 days after DAPT initiation. At 12 months, the incidence of thrombotic events was assessed and patients were classified into two groups: Group 1 – patients without thrombotic complications, Group 2 – patients with thrombotic complications.
Results. In both groups, aggregometry parameters were within target ranges under DAPT. Mass-spectrometric analysis revealed 10 differentially represented proteins between groups, five of which are involved in immune system regulation. Univariate logistic regression identified the strongest predictors of thrombotic events: circulating monocyte count (log ORstd = 2,109; 95% CI 2,724–1196,471; p = 0,007) and concentrations of several plasma proteins – inter-α-trypsin inhibitor heavy chain H4 (log ORstd = 1,112; 95% CI 0,245–2,167; p = 0,013), gelsolin (log ORstd = 1,064; 95% CI 0,240–2,097; p= 0,011), C1-esterase inhibitor (log ORstd = –1,776; 95% CI –3,861…–0,217; p = 0,024),
and phospholipid transfer protein (log ORstd = –2,145; 95% CI –4,503…–0,482; p = 0,008).
Conclusion. We identified factors whose levels are associated with increased risk of thrombotic complications in CCS patients after PCI. Thrombotic complications in CCS patients may be driven by immune system activation and an imbalance in the fibrinolytic system. Further research is required before clinical implementation of these factors as biomarkers.
About Authors
- Aleksandra S. Anisimova, Cardiologist; ORCID
- Georgiy I. Rusakovich, Biostatistician; ORCID
- Elena V. Maryukhnich, Junior Researcher 1, 2; ORCID
- Oksana I. Ivanova, Researcher 1, Junior Researcher 2; ORCID
- Elena L. Kordzaya, Cardiologist; ORCID
- Antonina K. Elizarova, Cardiologist; ORCID
- Aleksey S. Kononikhin, Senior Researcher; ORCID
- Anna E. Bugrova, Senior Researcher 3, 4; ORCID
- Natalya V. Zakharova, Senior Researcher 3, 4; ORCID
- Evgeniy N. Nikolaev, Dr. Phys.-Math. Sci., Professor, Corresponding Member of Russian Academy of Sciences, Director of Project Center of Omics Technologies and Advanced Mass Spectrometry; ORCID
- Elena Yu. Vasilieva, Dr. Med. Sci., Professor of Cardiology Chair, Head of Laboratory of Atherothrombosis 1, president 2; ORCID
