Acute coronary syndrome: investigation of vulnerability (plaque, blood and myocardium), optimal treatment and determination of the factors for the prognosis

Acute coronary syndrome (ACS), leading cause of morbidity and mortality in Serbia, represents a significant health and socioeconomic issue. Certain centers in Serbia in a short timeframe treat fivefolds the number of ACS patients (pts) treated in the leading cardiovascular centers, which is a great opportunity for integrative interdisciplinary investigations (III), as etiopathogenesis and therapy of ACS still harbor many unresolved mysteries. The disease involves plaque, prothrombotic blood features and myocardial vulnerability to ishemia. The main focus remains on pts with primarily ST-elevation, while as controls we’ll be using healthy subjects, athletes as well as other pts with other forms of coronary artery disease (CAD) – from stable angina up to pts with myocardial bridges (MBs). This multi-centric III carried out in Serbia on consecutive pts, will explore all possible factors leading to ACS, as well as optimal treatment options, reperfusion methods and methods of myocardial ischemic postconditioning (IPC). One of the aims of this III is to look into prognostic factors in particular in pts with diabetes (DM) in terms of therapeutic steps taken and their own defense mechanisms (oxidative status, number and functionality of stem cells) compared to controls. Quality of life features (types of personality, erectile dysfunction) and adequate lifestyle (nutrition principles, physical fitness, smoking and psychosocial stress abstinence) will be investigated, too.