Comprehensive assessment of vascular lesions in predicting cardiovascular events in atherosclerosis and carbohydrate metabolism disorders

Abstract

The article presents the results of a cluster analysis of the contribution of immune inflammationmarkers and endothelial dysfunction (ED) to the cardiovascular complicationsfrequency and severity in cohorts of patients with asymptomatic atherosclerosis (AAS), coronary artery disease (CAD), tyepe 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) during 3 years of prospective observation. A comparative analysis of the spectrum of the examined markers was performed depending on the stage of the development of the disease, the presence of T2DM and the MS. It was revealed that the greatest contribution to the cardiovascular complications development in AAS is provided by such circulating markers of ED and immune inflammation as ET-1, IL-1β, TNF-α, total autoantibodies to type I and III collagen (a-Coll) and to Chondroitine-sulfate (a-ChS). With IHD, the greatest contribution is provided by ET-1, eNOs, antibodies a-Coll and also IL-6 and vWf.In T2DM patients without CAD, a profile of markers associated with the high rate of adverse events includes ET-1, eNOs, IL-6, a-Coll and antibodies against hyaluronic acid (a-HA). In a cohort of patients with chronic CAD in the setting of T2DM, a profile of markers associated with the development of adverse events includes vWf, TNF-α, as well as the level of eNOs, IL-6, a-Coll, a-HA and CRP. In the cases of AAS without concomitant MS, the greatest contribution is due to the increase in the level of ET-1, vWf, a-Coll and a-ChS content; in the presence of MS — IL-1β, TNF-α, a-Coll, anti-ChS, anti-HA and CRP. In CAD without MS profile of markers associated with the development of adverse events, includes ET-1, eNOs and a-HA, the presence of the MS — a-Coll, ET-1 and IL-6 levels.