cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1139Research ArticleИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦАCORONARY HEART DISEASEЛабораторные и генетические маркеры в стратификации риска ишемической болезни сердцаLaboratory and genetic markers in coronary risk stratificationНазаренкоГ. И.NazarenkoG. I.

Москва

Moscow

КлейменоваЕ. Б.KleymenovaE. B.

Москва

Moscow

klimenova@medcenter.msk.ruГущинаН. Н.GushchinaN. N.

Москва

Moscow

Медицинский центр Банка РоссииMedical Centre, Bank of Russia200920022009813541Copyright © Назаренко Г.И., Клейменова Е.Б., Гущина Н.Н., 20092009Назаренко Г.И., Клейменова Е.Б., Гущина Н.Н.Nazarenko G.I., Kleymenova E.B., Gushchina N.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1139Цель

Цель. Оценить диагностическую эффективность лабораторных и генетических маркеров в комбинации с традиционными факторами риска (ФР) для прогнозирования риска развития ишемической болезни сердца (ИБС).

Материал и методы

Материал и методы. Обследован 131 пациент с диагнозом ИБС, верифицированным при коронаро-графии, и 159 человек — контрольная группа. Всем пациентам были исследованы следующие лабораторные маркеры£ липидный профиль,, липопротеин (а), высокочувствительный С-реактивный белок (вч-СРБ), D-димер, фибриноген, гомоцистеин, фолиевая кислота и витамин В12. Были изучены 29 полиморфизмов в 27 генах, которые согласно международным базам данных ассоциируются с ИБС.

Результаты

Результаты. Среди лабораторных маркеров вч-СРБ, липопротеин (а) и D-димер были независимыми Br-СРБ предикторами ИБС. При анализе результатов генетического обследования полиморфизмы 4 генов (АроЕ, PAI-1, GPIIIa, UCP2) статистически значимо ассоциировались с риском развития ИБС с поправкой на традиционные ФР. Площадь под характеристической кривой AUC ROC для модели, включающей традиционные ФР, дополнительные лабораторные маркеры и генетические маркеры, составила 88 %.

Заключение

Заключение. Комбинация результатов лабораторного и генетического тестирования с традиционными ФР позволяет значительно повысить прогностическую значимость оценки коронарного риска. Сопоставление генотипа с фенотипическими лабораторными маркерами необходимо для понимания их роли в патогенезе ИБС.

Aim

Aim. То assess diagnostic effectiveness of laboratory and genetic markers in combination with traditional risk factors (RFs) for coronary heart disease (CHD) prediction.

Material and methods

Material and methods. In total, 131 patients with CHD, verified at coronary angiography, and 159 controls were examined. In all participants, the levels of the following laboratory markers were measured: lipid profile, lipoprotein (a), highly specific C-reactiveprotein (hs-CRP), D-dimer, fibrinogen, folic acidandB12 vitamin. Additionally, 29 polymorphisms of 27 genes, associated with CHD, were examined.

Results

Results. Among laboratory markers, hs-CRP, lipoprotein (a) and D-dimer were independent CHD predictors. Polymorphisms of 4 genes (ApoE, PAI-1, GPIIIa, UCP2) were significantly associated with an increased CHD risk, after controlling for traditional RFs. For the model including traditional RFs, additional laboratory and genetic markers, AUC ROC was 88 %.

Conclusion

Conclusion. The combination oflaboratory and genetic markers with traditional RFs substantially improves prognostic quality of CHD risk assessment. Considering genotype and phenotype markers together is important for better understanding of their role in CHD pathogenesis.

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The authors declare that there are no conflicts of interest present.