Характер анатомічного ураження коронарного русла в пацієнтів з гострим інфарктом міокарда без елевації сегменту ST залежно від рівня стимулюючого фактору росту, що експресується ґеном 2 в плазмі та ризику несприятливих подій

Abstract

Aim. Assessment of the character of anatomical coronary lesions in patients with acute myocardial infarction without ST elevation depending on plasma level of gene 2 growth stimulating factor (ST2), and risk of adverse events.  Materials and Methods. Ninety patients with acute myocardial infarction without ST elevation (NSTEMI) aged 38 to 79 (mean 61.3±1.1) years were examined. Among them, 60 (66.7%) patients were male. The study evaluated the risk of adverse events on the GRACE scale; the character of anatomical lesions of the coronary arteries using invasive coronary ventriculography; and the level of ST2 in the blood plasma by enzyme immunoassay. Results and Discussion. It was found that the severity of myocardial infarction without ST segment elevation, depending on the GRACE score, was associated with the nature of the coronary lesion. In most patients with a high GRACE score (>140 points), prevalence of hemodynamically significant stenoses was found. In addition, these patients presented with a significant increase in three-vessel lesions of the coronary arteries. Instead, with less than 140 GRACE score, the number of patients without hemodynamically significant coronary artery stenoses increased significantly, and the number of patients with three-vessel lesions decreased. Conclusions. A connection of ST2 level with the severity of anatomical injury of coronary arteries in patients with NSTEMI was established. The total score of lesions of the coronary arteries increased  according to the increase in the level of ST2. An association of the GRACE score was established with the risk of adverse events in patients with NSTEMI.