Laboratory markers in prognosis of adverse coronary events in patients with cardiovascular disease who underwent percutaneous coronary interventions

Objective. Study analysis on the concentration of the laboratory markers in patients with cardiovascular disease (CVD) before percutaneous coronary intervention (PCI) and within a year after coronary stent introduction. Material and methods. This article presents the data collected through annual (one-year) observation of 71 patients after they had undergone PCI (58 patients, who didn’t have any complications, and 13, who got restenosis or clinical significant stenosis in a new site). All participants of the study had their investigated clinical blood test with automatic counting of the leukocyte formula, C-reactive protein, fibrinogen, uric acid, markers of lipid metabolism, calculating the coefficient of atherogenicity, the concentration of secretory phospholipase A2 and the level of antibodies to oxidized low-density lipoproteins, before the operation as well as 3, 6 and 12 months after PCI. Results. Significant differences in the level of peripheral biomarkers in groups with different variants of postoperative course were not revealed. A greater variability in the values of inflammation markers throughout the observation period and an increase in the level of secretory phospholipase A2 at 6 months after percutaneous coronary interventions in the group followed by complications of stenting (p < 0.05) is shown. Patients with adverse course of the postoperative period are characterized by a lower level of antibodies to oxidized LDL, with a lower coefficient of variation, compared to the control group. Conclusions. Determination of the activity of secretory phospholipase A2 (IIA) in the serum after PCI can be useful as a prognostic marker for identifying patients at increased risk of adverse coronary events.

secretory phospholipase A2, percutaneous coronary intervention, coronary stent introduction, cardiac markers, biomarker, cardiovascular disease

1. В. С. Фисенко, Н. И. Рогинко, А. В. Корочкин Выполнение основных целевых показателей по снижению смертности от болезней системы кровообращения в субъектах Российской Федерации (по результатам контрольно-надзорных мероприятий Росздрав-надзора). Вестник росздравнадзора № 5-2016 с. 26-32.

2. Бокерия Л. А., Гудкова Р. Г. Сердечно-сосудистая хирургия. 2013.

3. Biomarkers Definitions Working G. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 2001; 69: 89-95.

4. Walter D. H., Fichtlscherer S., Sellwig M., et al. Preprocedural C-reactive protein levels and cardiovascular events after coronary stent implantation. // J Am Coll Cardiol.- 2001 - Vol. 37.- pp. 839-846.

5. Шевченко О. П. Высокочувствительный анализ С-реактивного белка и его применение в кардиологии. // Лабораторная медицина.- 2003.- № 6.- стр. 35-І1.

6. Карпов Ю. А., Сорокин Е. В., Фомичева О. А. Воспаление и атеросклероз: состояние проблемы и нерешенные вопросы. // Сердце.- 2003.- № 4.- стр. 190-193.

7. Lowe GD. Fibrinogen assays for cardiovascular risk assessment. Clin Chem 2010; 56: 693-695.

8. Danesh J, Lewington S, Thompson SG, et al. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant metaanalysis. JAMA.

9. Kaptoge S, Di Angelantonio E, Pennells L, et al. C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 2012; 367: 1310-1320.

10. Holme I, Aastveit AH, Hammar N, et al. Inflammatory markers, lipoprotein components and risk of major cardiovascular events in 65005 men and women in the Apolipoprotein Mortality rISk study (AMorlS) Atherosclerosis. 2010; Nov; 213(1):299-305.

11. Men M, Zhang L, Li t, et al. Prognostic Value of the Percentage of Neutrophils on Admission in Patients with St-elevated Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Arch Med res. 2015 May; 46 (4): 274-9.

12. Fabbrini E, Serafini M, Colic Baric I, et al. Effect of plasma uric acid on antioxidant capacity, oxidative stress, and insulin sensitivity in obese subjects. Diabetes 2014; 63: 976-981.

13. Jin YL, Zhu T, Xu L, et al. Uric acid levels, even in the normal range, are associated with increased cardiovascular risk: the Guangzhou Biobank Cohort Study. Int J Cardiol 2013; 168: 2238-2241.

14. Dutta A, Henley W, Pilling LC, et al. Uric acid measurement improves prediction of cardiovascular mortality in later life. J Am Geriatr Soc 2013; 61: 319-326.

15. Шогенова М.Х., Жетишева Р. А., Карпов А. М., Доценко Ю. В., Масенко В. П., Наумов В.Г Роль окисленных липопротеинов низкой плотности и антител к ним в иммунно-воспалительном процессе при атеросклерозе. // Атеросклероз и дислипидемии.-2015.-№ 2 - с. 17-21

16. Душкин М. И. Вакцины против атеросклероза: настоящее и будущее. // Атеросклероз. Научно-практический журнал.-2011.- № 1 - с35-37.

17. Огуркова О. Н., Суслова Т. Е., Левашкина Е. А., Кулагина И. В., Лихоманов К. С., Кошельская О. А. Изменение содержания окисленно-модифицированных липопротеинов низкой плотности и антител к ним при применении аторвастатина у больных с ишемической болезнью сердца // СМЖ - 2008.- № 4-2 - c. 21-23.

18. Stafforini DM, McIntyre TM, Zimmerman GA, et al. Platelet-activating factor acetylhydrolases. J Biol Chem 1997; 272: 17895-17898.

19. Jonsson-Rylander AC, Lundin S, Rosengren B, et al. Role of secretory phospholipases in atherogenesis. Curr AtherosclerRep 2008; 10:252-259.

20. Rosengren B, Peilot H, Umaerus M, et al. Secretory phospholipase a2 group v: lesion distribution, activation by arterial proteoglycans, and induction in aorta by a western diet. Arterioscler Thromb Vasc Biol 2006; 26: 1579-1585.

21. ElinderLS, Dumitrescu A, Larsson P, Hedin U, Frostegard J, Claesson HE: Expression of phospholipase A2 isoforms in human normal and atherosclerotic arterial wall. Arterioscler Thromb Vase Biol 1997; 17:2257-2263.

22. Mallat Z, Benessiano J, Simon T, et al. Circulating secretory phospholipase a2 activity and risk of incident coronary events in healthy men and women: the epic-norfolk study. Arterioscler Thromb Vasc Biol2007; 27: 1177-1183.

23. Lind L, Simon T, Johansson L, et al. Circulating levels of secretory-and lipoprotein-associated phospholipase a2 activities: relation to atherosclerotic plaques and future all-cause mortality. Eur Heart J 2012; 33: 2946-2954.

24. Коротаева А. А. Секреторная фосфолипаза A2 группы IIa в сыворотке крови больных после коронарной ангиопластики: регуляция липидами и липопротеидами. Автореферат диссертации. М., 2009.