Introduction: The need for coronary artery bypass surgery in patients with acute coronary syndrome totals 10%. Despite the proven high efficacy of surgical myocardial revascularization, the risk of recurrent cardiovascular complications in the long-term follow-up persists, which necessitates the development of a personalized approach to medication therapy.
Purpose: To develop prognostic models of the cardiovascular complication probability in patients with unstable angina, and to conduct a comparative assessment of standard and personalized approach to antithrombotic therapy. Material and methods: The control group consisted of 106 patients with coronary artery bypass surgery and the standard approach to medication therapy. The treatment group was represented by 61 patients with adjusted antithrombotic and hypolipidemic therapy in the postoperative period.
Results: Independent predictors of myocardial infarction and cardiovascular mortality in the long-term follow-up period in patients with unstable angina and coronary artery bypass surgery included: D-dimer ?560 ng/mL (OR 3.721; 95% CI 1.374–10.074), homocysteine ?15 ?mol/L (OR 3.674; 95% CI 1.351–9.949), NTproBNP ?546 pg/mL (OR 3.5; 95% CI 1.362–9.934), endogenous thrombin potential ?2200 nM*min (OR 3.250; 95% CI 1.196–8.830), and hsCRP ?5.8 g/L (OR 1.625; 95% CI 1.008–2.958), creatinine ?110 (OR 2.473; 95% CI 1.085–5.634), and myeloperoxidase ?320 pmol/L (OR 2.231; 95% CI 1.109–4.432) determined one month after coronary bypass surgery. A personalized approach to antithrombotic therapy resulted in a 2.2-fold (p=0.003) reduction in the relative risk of recurrent cardiovascular complications during the seven-year follow-up period. 
Conclusion: Development of complications in the long-term postoperative period is associated with residual thrombogenic and atherogenic risk, which is manifested by excessive values of thrombin generation test, D-dimer level, hsCRP, myeloperoxidase, ADP AUC one month after coronary artery bypass surgery. Personalized approach to antithrombotic therapy in patients with unstable angina is not only associated with improved prognosis and quality of life of the operated patients, but also is a reasonable measure from the economic point of view.

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