Characteristics of anatomic injury of coronary arteries in patients with acute myocardial infarction without ST elevation depending on plasma level of gene 2 growth stimulating factor and risk of adverse even
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.
Ciccone M.M., Cortese F., Gesualdo M., Riccardi R., Di Nunzio D., Moncelli M., Iacoviello M., Scicchitano P. A novel cardiac biomarker: ST2: a review. Molecules. 2013; 18(12):15314-28. doi: 10.3390/ molecules181215314. https://doi.org/10.3390/molecules181215314
Concept of the National Program "Healthy Nation for 2012-2016" [Electronic resource] - Access mode: http://zakon2.rada.gov.ua/laws/show/828-2011-%D1%80.
2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC), European Heart Journal, Volume 39, Issue 2, 07 January 2018, Pages 119-177.
European Database for Health for All statistics [Electronic resource]. - Access mode: http://medstat.gov.ua/eng/normdoc.html.
Fox KA, Eagle KA, Gore JM, Steg PG, Anderson FA. The Global Registry of Acute Coronary Events, 1999 to 2009-GRACE. Heart 2010;96:1095-1101. https://doi.org/10.1136/hrt.2009.190827
Fox KA, FitzGerald G, Puymirat E, et al. Should patients with acute coronary disease be stratified for management according to their risk? Derivation, external validation and outcomes using the updated GRACE risk score. BMJ 2014; 4 (2): e004425. https://doi.org/10.1136/bmjopen-2013-004425
Kovalenko V.M., Kornatskiy V.M. Regional medical and social problems of circulatory system diseases. Dynamics and analysis, 2013: 239 р. Ukrainian:
Lupin J., Gaggin H.K., de Antonio M., Domingo M., Galan A., Zamora E., Vila J., Peтafiel J., Urrutia A., Ferrer E., Vallejo N., Januzzi J.L., Bayes-Genis A. Biomarker-assist score for reverse remodeling prediction in heart failure: The ST2-R2 score. Int J Cardiol. 2015;184:337-43. doi: 10.1016/j. ijcard.2015.02.019. https://doi.org/10.1016/j.ijcard.2015.02.019
MOH of Ukraine Order No.164 of 03.03.2016 "On Approval and Implementation of Medical Documents on Standardization of Medical Assistance in Acute Coronary Syndrome without ST segment elevation" Unified clinical protocol of emergency, primary, secondary (specialized) and tertiary (specialized) Acute coronary syndrome without ST segment elevation Adapted clinical evidence-based Acute coronary syndrome without ST segment elevation.
Morikami Y, Natsuaki M, Morimoto T, et al. Impact of polyvascular disease on clinical outcomes in patients undergoing coronary revascularization: an observation from the CREDO-Kyoto Registry Cohort-2. Atherosclerosis 2013; 228 (2): 426-31. https://doi.org/10.1016/j.atherosclerosis.2013.04.005
Rehman S.U., Mueller T., Januzzi J.L. Characteristics of the novel interleukin family biomarker ST2 in patients with acute heart failure. J. Am. Coll. Cardiol. 2008: 52 (18): 1458-65. doi:10.1016/j.jacc.2008.07.042 54. https://doi.org/10.1016/j.jacc.2008.07.042
Sabatine M. S., Morrow D. A., Higgins L. J. et al. Complementary roles for biomarkers of biomechanical strain ST2 and N-terminal prohormone B-type natriuretric peptide in patients with ST-elevation myocardial infarction. Circulation. 2008. Vol. 117. P. 1936-1944. https://doi.org/10.1161/CIRCULATIONAHA.107.728022
Savonitto S, Ardissino D, Granger CB, Morando G, Prando MD, Mafrici A, Cavallini C, Melandri G, Thompson TD, Vahanian A, Ohman EM, Califf RM, Van de Werf F, Topol EJ. Prognostic value of the admission electrocardiogram in acute coronary syndromes. JAMA 1999;281:707-713. https://doi.org/10.1001/jama.281.8.707
Shah R.V., Januzzi J.L. ST2: a novel remodeling biomarker in acute and chronic heart failure. Curr Heart Fail Rep. 2010;7 (1): 9-14. doi:10.1007/ s11897-010-0005-9. https://doi.org/10.1007/s11897-010-0005-9
Shimpo M., Morrow D. A., Weinberg E. O. et al. Serum levels of the interleukin-1 receptor family member ST2 predict mortality and clinical outcome in acute myocardial infarction. Circulation. 2004. Vol. 109. 2186-2190. https://doi.org/10.1161/01.CIR.0000127958.21003.5A
This work is licensed under a Creative Commons Attribution 4.0 International License.