Clinical and prognostic value of pathogenetic markers of vascular wall lesion in asymptomatic atherosclerosis

The article presents the results of a comparative cohort prospective study that was conducted to explore the nature of changes in the levels of circulating markers of endothelial dysfunction (ED), pro-inflammatory cytokines and the levels of antibodies to connective tissue components of the vascular wall at the stage of subclinical asymptomatic atherosclerosis in order to optimize the therapeutic and diagnostic approach to this category of patients from the position of more accurate stratification of the nearest risk of development of adverse cardiovascular events. ELISA tested the levels of endothelin-1 (ET-1), von Willebrand factor (fWB), concentration of endothelial nitric oxide synthase (eNOs), levels of total auto-antibodies to collagen I and III types (anti-K), auto-antibodies to hyaluronic acid (anti-HA) and chondroitin sulfate (a-HS) in persons with asymptomatic atherosclerotic lesion of the vascular wall according to the instrumental methods of the study and in persons without atherosclerotic vascular lesions. Significantly elevated levels of circulating markers of ED, auto-antibodies and pro-inflammatory cytokines were revealed in asymptomatic atherosclerosis in comparison with the control group. On the basis of statistical methods, we determined the most informative three-year markers of unfavorable course of cardiovascular pathology in asymptomatic atherosclerosis. Thus, the level of IL-1ß more than 110 pg/ml in subclinical atherosclerosis is associated with an increased 3-year risk of death from coronary heart disease, the total serum concentration of antibodies to collagen I and III types more than 0.23 μg/ml is associated with a significant increase in the risk of ACS, and serum ET-1 concentrations of more than 1.18 fmol/ml are associated with an increased likelihood of the debut of primary chronic forms of ischemic heart disease within the next three years.

endothelial dysfunction, inflammation, cytokines, auto-antibodies, atherosclerosis, ischemic heart disease

1. Бабаева А. Р., Тарасов А. А., Давыдов С. И., Емельянова А. А. Иммунологические маркеры дисфункции сосудистого эндотелия в диагностике острого коронарного синдрома // Вестник ВолгГМУ, Волгоград, 2006. № 3 (19). С. 18-23.

2. Безбородова Т. А., Тарасов А. А., Резникова Е. А., Аекарева И. В., Захарьина О. А., Бабаева А. Р. Диагностическое использование новых патогенетических маркеров поражения сосудистой стенки у больных сахарным диабетом // Цитокины и воспаление. 2014. Т. 13, № 1. С. 28-33.

3. Бойцов С. А., Кухарчук В. В., Карпов Ю. А. и др. Субклинический атеросклероз как фактор риска сердечно-сосудистых осложнений // Кардиоваскулярная терапия и профилактика, 2012; 11 (3): 82-86.

4. ГОСТ Р 52379-2005. Национальный стандарт Российской Федерации. Надлежащая клиническая практика - Good Сlinical Practices (GCP). М. Стандартинформ. 2014. 32 с.

5. Гуревич В. С. Современные представления о патогенезе атеросклероза // Болезни сердца и сосудов. 2006. № 4. С. 4-8.

6. Катамадзе Н. О., Берштейн А. А., Гришкин Ю. Н. Диагностика субклинического атеросклероза как элемент современной стратегии стратификации сердечно-сосудистого риска // Кардиоваскулярная терапия и профилактика, 2012; 11 (2): 76-84.

7. Аутай М. И. Атеросклероз: современный взгляд на патогенез // Укр. кардиол. журн. 2004. № 1. С. 23-24.

8. Нагорнев В. А. Патогенез атеросклероза. // СПб, Изд-во ЗАО «Хромис». 2006. 240 с.

9. Hanley J. A., McNeil B. J. The meaning and use of area under a receiver operating characteristic (ROC) curve // Radiology. 1982. V. 143. № 1. P. 29-36.

10. Kottke T. E. The lessons of COURAGE for the management of stable coronary artery disease. JACC 2011; 58 (2): 138-9.