cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1550Research ArticleИНФАРКТ МИОКАРДАMYOCARDIAL INFARCTIONСостояние системы цитохрома Р-450 3А4 у больных острым инфарктом миокардаCytochrome P-450 3A4 system in patients with acute myocardial infarctionВладимировА. Г.VladimirovA. G.drvl@mail.ruКукесВ. Г.KukesV. G.drvl@mail.ruАндреевД. А.AndreevD. A.drvl@mail.ruГУЗ Госпиталь для ветеранов войн №3РоссияГУЗ Госпиталь для ветеранов войн №3Russian FederationИнститут клинической фармакологии ФГУ “НЦ ЭСМП” РосздравнадзораРоссияClinical Pharmacology Institute, Research Center for Medical Substances ExpertiseRussian FederationМосковская медицинская академия им. И.М. Сеченова, г. МоскваРоссияI.M. Sechenov Moscow Medical Academy. MoscowRussian Federation200820082008743540Copyright © Владимиров А.Г., Кукес В.Г., Андреев Д.А., 20082008Владимиров А.Г., Кукес В.Г., Андреев Д.А.Vladimirov A.G., Kukes V.G., Andreev D.A.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/1550Цель

Цель. Определить особенности функционирования системы CYP3A4 в остром периоде инфаркта миокарда (ИМ), ее связь с клинико-лабораторными показателями.

Материал и методы

Материал и методы. В исследование были включены 50 пациентов, госпитализированных в первые 24 часа острого инфаркта миокарда с подъемом сегмента ST (HMnST). (MEGX) - Тест моноэтилглици-нэксилидида проводили сразу после поступления пациента, до назначения терапии, на 4-5 и 14 сутки заболевания.

Результаты

Результаты. Исходный уровень MEGX оказался достоверно выше в группе неосложненного течения ИМ (132,1+16,85 нг/мл), чем в группе пациентов с симптомами сердечной недостаточности (СИ) (31,9+2,02 нг/мл; р<0,001) и группе здоровых добровольцев (63,6+14,01 нг/мл; р<0,001). Прием фенобарбитала достоверно повышает активность CYP 3A4 в обеих группах пациентов с ИМ.

Заключение

Заключение. Активность системы CYP 3A4 в остром периоде HMnST угнетена у пациентов при наличии признаков острой СИ. Это связано с развитием у пациентов этой группы признаков повреждения печени (ишемического и застойного характера). При HMnST возможно проведение фармакологической стимуляции CYP 3A4.

Aim

Aim. To investigate CYP 3A4 system functioning and its clinico-laboratory correlations in acute myocardial infarction (AMI).

Material and methods

Material and methods. The study included 50 patients hospitalized in the first 24 hours of AMI with ST segment elevation (STE-AMI). Monoethylglycinexylidide (MEGX) test was performed at the hospital admission, at Day 4-5 and Day 14.

Results

Results. Baseline MEGX level was significantly higher in non-complicated AMI group (132,1+16,85 ng/ml) than in patients with heart failure (HF) symptoms (31,9+2,02 ng/ml; p<0,001) or healthy volunteers (63,6+14,01 ng/ ml; p<0,001). Phenobarbital administration significantly enhanced CYP 3A4 activity in both AMI groups.

Conclusion

Conclusion. In AMI, CYP 3A4 system activity was suppressed among patients with acute HF symptoms. This could be explained by ischemic and congestive liver disturbances. In STE-AMI, pharmacological CYP 3A4 stimulation is possible.

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