cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2013-3-18-23cardiovascular-188Research ArticleИНФАРКТ МИОКАРДАMYOCARDIAL INFARCTIONСЫВОРОТОЧНЫЕ МАРКЕРЫ АПОПТОЗА И КЛАССИЧЕСКИЕ ФАКТОРЫ РИСКА У БОЛЬНЫХ ИНФАРКТОМ МИОКАРДА И ЗДОРОВЫХ ЖИТЕЛЕЙ АРХАНГЕЛЬСКОЙ ОБЛАСТИ: ТЕНДЕНЦИИ, ПРИЧИНЫ, ПОСЛЕДСТВИЯSERUM MARKERS OF APOPTOSIS AND CONVENTIONAL RISK FACTORS IN PATIENTS WITH MYOCARDIAL INFARCTION AND HEALTHY RESIDENTS OF ARKHANGELSK REGION: TRENDS, CAUSES, AND CONSEQUENCESЯковлеваА. С.YakovlevaA. S.

ассистент кафедры факультетской терапии с курсом эндокринологии, 2врач-терапевт отделения кардиохирургии

Тел.: 8 (8182) 63 29 88 

tel.: 8 (8182) 63 29

fox_anyut@mail.ruМиролюбоваО. А.MirolyubovaO. A.

д. м.н., проф., заведующая кафедрой факультетской терапии с курсом эндокринологии

СупрядкинаТ. В.SupryadkinaT. V.

к. м.н., заведующая отделением неотложной кардиологии

ГБОУ ВПО «Северный государственный медицинский университет» Министерства здравоохранения Российской Федерации, АрхангельскNorthern State Medical University, ArkhangelskГБУЗ Архангельской области «Первая городская клиническая больница им. Е. Е. Волосевич»E.E. Volosevich First City Clinical Hospital2013200620131231823Copyright © Яковлева А.С., Миролюбова О.А., Супрядкина Т.В., 20132013Яковлева А.С., Миролюбова О.А., Супрядкина Т.В.Yakovleva A.S., Mirolyubova O.A., Supryadkina T.V.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/188Цель

Цель. Оптимизация стратификации риска на основе определения активности Fas-опосредованного апоптоза в раннем и позднем постинфарктных периодах у молодых пациентов.

Материал и методы

Материал и методы. Обследованы 28 молодых (42,5±5,6 лет) и 56 пожилых (63,0±7,8 лет) больных инфарктом миокарда (ИМ) и 66 здоровых добровольцев. Оценивались: традиционный профиль риска ишемической болезни сердца (ИБС), липидограммы, данные электрокардиографии, эхокардиоскопии, коронароангиографии; уровни биомаркеров апоптоза sFas, sFasL, а также Cys C, BNP-32 определялись методом иммуноферментного анализа через 2 нед. и 7,0 (5,7–10,9) мес. после ИМ.

Результаты

Результаты. Выявлена зависимость концентрации sFasL от пола: 65,09±36,95 у женщин vs 77,27±27,48 пг/мл у мужчин (р=0,008). Уровни sFasL оказались более высокими — 80,18±40,54 пг/мл у молодых больных ИМ по сравнению со здоровыми лицами — 58,38±25,79 пг/мл (р=0,012). Уровни sFas не имели значимых отличий. Курение обусловливало большую концентрацию sFas. Были определены связи уровней sFasL с липидограммой, уровнем фибриногена, индексом массы тела. Больные с артериальной гипертонией имели более высокую концентрацию sFasL: 81,80±37,98 vs 55,30±11,96 пг/мл (р=0,029). Выявлена зависимость отношения sFas/sFasL от количества компонентов метаболического синдрома (МС). Для прогнозирования нового коронарного события в течение 6–8 мес. у молодых больных может быть использован уровень sFasL через 2 нед. после ИМ (чувствительность 75%, специфичность 90%).

Заключение

Заключение. Концентрация sFasL у молодых больных ИМ была выше таковой у здоровых лиц. Уровень sFasL имел обратную взаимосвязь с количеством компонентов МС, а также прогностическую ценность для рецидива стенокардии у молодых больных ИМ через 6–8 мес. 

Aim

Aim. To improve the risk stratification in young patients with myocardial infarction (MI), using the data on the Fas-mediated apoptosis activity in early and late post-infarction periods.

Material and methods

Material and methods. The study included 28 young MI patients (mean age 42,5±5,6 years), 56 elderly MI patients (mean age 63,0±7,8 years), and 66 healthy volunteers. The following parameters were assessed 2 weeks and 7 months (5,7–10,9 months) after MI: conventional risk factors of coronary heart disease (CHD), lipid profile, electrocardiography, echocardiography, and coronary angiography parameters, the levels of apoptosis biomarkers (sFas, sFasL), Cys C, and BNP-32 (immunoenzymatic method).

Results

Results. The mean concentration of sFasL varied by gender, reaching 65,09±36,95 pg/ml in women vs. 77,27±27,48 pg/ml in men (р=0,008). The levels of sFasL were higher in young MI patients (80,18±40,54 pg/ ml), compared to healthy volunteers (58,38±25,79 pg/ml; р=0,012), while there was no marked variation in the levels of sFas. Smoking was associated with higher sFas levels. The concentration of sFasL was associated with the levels of blood lipids, fibrinogen, and body mass index. Patients with arterial hypertension had a higher concentration of sFasL (81,80±37,98 pg/ml) than their non-hypertensive peers (55,30±11,96 pg/ml; р=0,029). The sFas/sFasL ratio was linked to the number of metabolic syndrome (MS) components. Among young MI patients, the levels of sFasL, measured 2 weeks after MI, could be used for the prediction of a new coronary event in the next 6–8 months (sensitivity 75% and specificity 90%).

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