Abstract
Aim. To perform comparative analysis of the pregnancy-associated plasma protein A and insulin-like growth factor 1 (PAPP-A and IGF-1) in blood plasma of patients with acute coronary syndrome (ACS). Prediction of 24-hour risk of fatal outcome in ACS. Material and methods. The concentrations of PAPP-A and IGF-I were assessed in 71 ACS patients, mean age 57 y. o. In the study group, during 24 hours myocardial infarction (MI) was diagnosed in 44, unstable angina in 27, and 9 fatal outcomes. Also, the concentrations of PAPP-A and IGF-I were measured in comparison and control groups. Comparison consisted of 40 hypertension patients with stable ischemic heart disease. Controls were 20 almost healthy persons. Results. In the study, there was increase of PAPP-A and IGF-I levels in ACS patients. In unstable angina patients PAPP-A is higher than in controls 3,56 times, and in MI patients 11,6 times. In MI, PAPP-A is 3,2 times higher than in unstable angina. In unstable angina patients there the highest levels of IGF-I, and 1,27 higher than in controls. In the study, we showed that IGF-I and PAPP-A levels in acute coronary pathology are linked to the outcome at the first day of the disease. Conclusion. It is aim full to apply PAPP-A and IGF-I to urgent cardiology practice as an analyzer of atherosclerotic plaque instability in acute coronary events, as a factor of life and disease prognosis.
Highlights
We showed that IGF-I and PAPP-A levels in acute coronary pathology are linked to the outcome at the first day of the disease
Ассоциированный с береprotein-A and proform of eosinophil major basic protein levels in patients with chronic менностью протеин плазмы А при остром коронарном синдроме
Summary
Во всем мире смертность от сердечно-сосудис тых заболеваний (ССЗ) на первом месте и составляет ~60% в структуре общей смертности. При этом степень активности сосудистого воспаления — наиболее важная характеристика деструктивных изменений в АБ. Было положено начало изучения белковых факторов роста и повреждения при ОКС — ассоциированный с беременностью протеин плазмы А (РАРР-А) и инсулиноподобный фактор роста 1 (IGF 1) [6, 7]. В последние годы много исследований плазмы крови на маркеры, характеризующие активность сосудистого воспаления: С-реактивный белок (СРБ); молекулы сосудистой и внутриклеточной адгезии, sVCAM-1, sICAM-1; интерлейкин-6 (ИЛ6); фибриноген, маркеры неоангиогенеза — плацентарный фактор роста (PLGF), инсулиноподобный фактор роста 1 (IGF 1) и эндогенной деструкции — РАРР-А (Pregnancy-Associated Plasma Protein A; ассоциированный с беременностью плазменный протеин А). Изменения концентраций РАРР-А и IGF-I при ИБС, можно рассматривать как один из механизмов активации процессов защиты и повреждения сосудистой стенки, показателем “нестабильных АБ” [8,9,10].
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