Laboratory markers of complicated coronary atherosclerosis in patients with non-ST-elevation myocardial infarction

Aim. To study the associations between the level of systemic inflammation markers in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and the severity of infarct-related artery (IRA) involvement according to coronary angiography.

Material and methods. The data of 236 patients hospitalized with a diagnosis of NSTEMI in the regional vascular center in Odintsovo from April 2021 to February 2023 were analyzed. All patients underwent examinations in accordance with clinical guidelines. Based on laboratory tests, the level of following inflammatory markers was assessed: leukocytes, high-sensitivity C-reactive protein (hsCRP), fibrinogen. During coronary angiography, the IRA involvement was assessed according to American College of Cardiology/American  Heart Association classification. The relationship of inflammatory markers with complicated involvement was assessed in a binary logistic regression model.

Results. Depending on the severity of the IRA involvement, the patients were divided into 2 following groups: group 1 included 166 patients with complicated IRA involvement (type B-C), group 2 — 70 patients without complicated IRA involvement (type A). Patients in both groups were comparable in terms of troponin I levels upon admission (p>0,05). Inflammatory markers were significantly higher in group 1 (p≲0,05). Fatal outcome was observed in 4,2% (n=7) of cases in group 1 and in 2,9% (n=2) in group 2 (p=0,62). Levels of hsCRP (odds ratio (OR) 1,19) and fibrinogen (OR 7,96) were associated with the probability of type B-C IRA lesion (p<0,001).

Conclusion. Patients with NSTEMI and complicated IRA lesions are characterized by elevated levels of systemic inflammation markers. Higher levels of hsCRP and fibrinogen were significantly associated with type B and C lesions.

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