PROGNOSIS OF ONE-DAY MORTALITY AND PROTEIN GROWTH AND DAMAGE FACTORS IN ACUTE CORONARY SYNDROME

Aim. To perform comparative analysis of the pregnancy-associated plasma protein A and insulin-like growth factor 1 (PAPP-A and IGF-1) in blood plasma of patients with acute coronary syndrome (ACS). Prediction of 24-hour risk of fatal outcome in ACS.

Material and methods. The concentrations of PAPP-A and IGF-I were assessed in 71 ACS patients, mean age 57 y. o. In the study group, during 24 hours myocardial infarction (MI) was diagnosed in 44, unstable angina in 27, and 9 fatal outcomes. Also, the concentrations of PAPP-A and IGF-I were measured in comparison and control groups. Comparison consisted of 40 hypertension patients with stable ischemic heart disease. Controls were 20 almost healthy persons.

Results. In the study, there was increase of PAPP-A and IGF-I levels in ACS patients. In unstable angina patients PAPP-A is higher than in controls 3,56 times, and in MI patients 11,6 times. In MI, PAPP-A is 3,2 times higher than in unstable angina. In unstable angina patients there the highest levels of IGF-I, and 1,27 higher than in controls. In the study, we showed that IGF-I and PAPP-A levels in acute coronary pathology are linked to the outcome at the first day of the disease.

Conclusion. It is aim full to apply PAPP-A and IGF-I to urgent cardiology practice as an analyzer of atherosclerotic plaque instability in acute coronary events, as a factor of life and disease prognosis.

1. Mazur NA Practical Cardiology. Moscow, Medpraktika. 2009; 11-26. (in Russ.) Мазур Н. А. Практическая кардиология. Москва. Медпрактика 2009; 11-26.

2. Atlas of health in Europe/2nd edition. Available from:http://www.euro.who.int/data/ assets/pdf_file/0012/97599/E91713R.pdf (Дата обращения: 05.04.2016). 3. Oganov RG. Сardiovascular disease in the early twenty-first century: medical, social, demographic aspects and ways of prevention. Federal guide: 2010; 257 р. (in Russ.) Оганов Р. Г. Сердечно-сосудистые заболевания в начале XXI века: медицинские, социальные, демографические аспекты и пути профилактики. Федеральный справочник 2010; 257 с.

3. Cardiovascular disease in the world. Epidemiology of coronary heart disease. Available from: http://meduniver.com/Medical/cardiologia/1294.html (Дата обращения: 05.04.2016).

4. 2015 — the year of fight against cardiovascular diseases in Russia. Available from: https://medaboutme.ru/zdorove/publikacii/stati/kardiorisk (Дата обращения: 05.04.2016).

5. Shevchenko OP, Slesareva Yu, Shevchenko AO. The role of PAPP-A in the development of atherosclerotic plaque damage in patients with coronary heart disease. Russian J Cardiol 2011; 2 (88): 65-71. (in Russ.) Шевченко О. П., Слесарева Ю. С., Шевченко А. О. Роль РАРР-А в развитии повреждения атеросклеротической бляшки у больных ишемической болезнью сердца. Российский кардиологический журнал 2011; 2 (88): 65-71. DOI:10.15829/1560-4071-2011-2-65-71

6. Li X, Liu Q, Zhou T. PAPP-A: a possible pathogenic link to the instability of atherosclerotic plaque. Med Hypotheses 2008; 70 (3): 597-9. 8. Rossen M, Iversen K, Teisner A, et al. Optimisation of sandwich ELISA based on monoclonal antibodies for the specific measurement of pregnancy-associated plasma protein (PAPP-A) in acute coronary syndrome. Clin Biochem 2007; 40 (7): 478-84.

7. Conover ChA, Harrington SC, Bale LK. Differential Regulation of Pregnancy Associated Plasma Protein-A in Human Coronary Artery Endothelial Cells and Smooth Muscle Cells Growth Horm. IGF Res 2008; 18 (3): 213-20.

8. Consuegra-Sanchez L. Prognostic value of circulating pregnancy-associated plasma protein-A and proform of eosinophil major basic protein levels in patients with chronic stable angina pectoris. Clin Chim Acta 2008; 391: 18-23. 11. Khosravi J, Diamandi A, Krishna RG, et al. Pregnancy associated plasma protein- A: ultrasensitive immunoassay and determination in coronary heart disease. Clin Biochem 2002; 35: 531-8.

9. Beaudeux JL, Burc L, Imbert-Bismut F, et al. Serum plasma pregnancy-associated protein A: a potential marker of echogenic carotid atherosclerotic plaques in asymptomatic hyperlipidemic subjects at high cardiovascular risk . Arterioscler Thromb Vasc Biol 2003; 23: 7-10.

10. Bunn RC, Fowlkes JL. Insulin-like growth factor binding protein proteolysis. Trends Endocrinol Metab 2003; 14: 176-81.

11. Ceska R, Stulc T, Zima T. PAPP-A, a novel marker of unstable plaque, is not influenced by hypolipidemic treatment in contrast to. Atherosclerosis 2003; 166: 195-6.

12. Martynov AI, Voevoda MI, Arutyunov GP, et al. Clinical efficacy of early diagnosis of acute myocardial infarction using protein that binds fatty acid. Russian J Cardiol 2012; 3 (95): 7-11. (in Russ.) Мартынов А. И., Воевода М. И., Арутюнов Г. П. и др. Клиническая эффективность ранней диагностики острого инфаркта миокарда с помощью белка, связывающего жирные кислоты. Российский кардиологический журнал 2012; 3 (95): 7-11. DOI:10.15829/1560-4071-2012-3-7-11

13. Kayumova GHk, Razin VA. Analysis of the growth and damage markers in acute coronary syndrome. Cardiology of Uzbekistan J; 2015; 2: 169. (in Russ.) Каюмова Г. Х., Разин В. А. Анализ маркеров роста и повреждения при остром коронарном синдроме. Kардиология Узбекистана 2015; 2: 169.

14. Razin VA, Kayumova GHk, Сhermisheva EV. Plasma protein in acute coronary. Ulyanovsk biomedical J 2013; 4: 16-9. (in Russ.) Разин В. А., Каюмова Г. Х., Чернышева Е. В. Протеин плазмы при остром коронарном. Ульяновский медико-биологический журнал 2013; 4: 16-9.

15. Razin VA, Gimaev RH, Chernyshova EV, et al. Markers of myocardial fibrosis in acute coronary syndromes. Ulyanovsk biomedical J 2014; 1: 19-24. (in Russ.) Разин В. А., Гимаев Р. Х., Чернышева Е. В. и др. Маркеры фиброза миокарда при остром коронарном синдроме. Ульяновский медико-биологический журнал 2014; 1: 19-24.

16. Sapozhnikov АN, Razin AB, Chernyshova EV, et al. Pregnancy of associated plasma protein A with acute coronary. Saratov Scientific Med J 2014; 1: 92-5. (in Russ.) Сапожников А. Н., Разин В. А., Чернышева Е. В. и др. Ассоциированный с беременностью протеин плазмы А при остром коронарном синдроме. Саратовский научно-медицинский журнал 2014; 1: 92-5).