IMMUNOLOGICAL AND HEMODYNAMIC PREDICTORS OF ACUTE CORONARY SYNDROME

MUKHAMEDOVA M.M, ZHARILKASINOVA G.ZH.

Key words:

ACUTE CORONARY SYNDROME, CORONARY HEART DISEASE, CYTOKINES, MYOCARDIAL INFARCTION

Abstract:

Introduction: Despite differences in their clinical manifestations, unstable angina and myocardial infarctio are the consequences of the same pathophysiological process - namely atherosclerosis plaque rupture or erosion in combination with associated thrombosis and embolization of distal areas of the vascular bed. Therefore, unstable angina and developing myocardial infarction, united by the term “acute coronary syndrome” (ACS), require a clear differential diagnosis due to the need to choose therapeutic tactics. Purpose of the study: To investigate study the cytokine profile in patients with acute coronary syndrome.

Materials and methods: The study comprised 86 hospitalized patients diagnosed with ACS, which included cases with transformation into acute non-ST segment elevation myocardial infarction and unstable angina. Inclusion criteria involved patients aged 46 to 65 years with a confirmed diagnosis of coronary artery disease, established through coronary angiography, as well as observed changes in the electrocardiogram and/or dynamics of cardiac-specific enzymes.

Results: In our study, the levels of IL-1β in Group 2 (52.8±1.55 pg/ml) and in Group 3 (50.1±1.23 pg/ml) were significantly 1.4 times higher than the control values (36.2±1.19 pg/ml). Additionally, TNFα levels in Group 2 (55.6±1.16 pg/ml) and in Group 3 (54.3±1.09 pg/ml) were 2.2 times higher than those in healthy individuals (24.5±0.86 pg/ml). These findings suggest the induction of an endogenous reaction aimed at the production of proinflammatory cytokines in response to ischemic myocardial damage in ACS. Сonclusions: Thus, elevated serum levels of IL-1β and TNFα indicate a more pronounced systemic inflammatory response in the group of patients with unstable angina. Furthermore, a significant twofold increase in the concentrations of cytokines IL-6 and VEGF-A is observed in patients with myocardial infarction, suggesting a heightened process of post-ischemic neoangiogenesis and inflammatory infiltration of the coronary vessel endothelium.