scholarly journals Comparative characteristics of the state of the immune system in patients with coronary artery disease with stable angina pectoris and acute coronary syndrome

2021 ◽  
Vol 28 (3) ◽  
pp. 30-40
Author(s):  
O. M. Lomakovsky ◽  
T. I. Gavrilenko ◽  
O. M. Parkhomenko ◽  
M. І. Lutay ◽  
O. A. Pidgaina ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Immune System ◽  
Coronary Artery ◽  
Mononuclear Cells ◽  
Blast Transformation ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Artery Disease

The aim – to assess the relationship between the state of the immune system and the development of acute coronary syndrome in patients with IHD.Materials and methods. The first group consisted of 64 patients with ST-segment elevation acute coronary syndrome, mean age 54 (49–64) years; the second group – 223 patients with coronary artery disease with stable exertional angina, FC II–III, mean age 56 (49–63) years; the third group – 47 patients with acute coronary syndrome without ST segment elevation, mean age 61 (52–65) years. The material for the immunological study was peripheral venous blood. To determine the parameters of cellular and humoral innate and adaptive immunity in blood serum and supernatants of mononuclear cells, enzyme immunoassay was used.Results and discussion. In patients with coronary artery disease with acute coronary syndrome with ST segment elevation compared with patients with coronary artery disease with stable angina pectoris, the levels of indicators of the immune status in the blood were: CRP – 9.3 (5.3–12.0) versus 4.8 (2.4–8.1) mg/L (p=0.0001), sICAM – 785 (690–830) versus 565 (406–744) ng/ml (p=0.0001), IL-10 in blood mononuclear cells – 48 (1–228) versus 194 (21–758) pg/ml (p=0.0007), circulating immune complexes – 90 (70–108) versus 76 (54–105) od. (p=0.045), lymphocytes with apoptosis (CD95) – 16 (9–27) versus 11 (8–17) % (p=0.029), spontaneous oxygen-dependent metabolism of monocytes – 16 (12–21) versus 13 (9–17) (p=0.001). The levels of indicators of the immune system in the blood in patients with coronary artery disease with acute coronary syndrome with ST segment elevation compared with patients with coronary artery disease with acute coronary syndrome without ST segment elevation were: T-helpers – 37 (32–41) versus 42 (37–48) % (p=0.0006) (R=–0.33; p=0.0005), reaction of lymphocyte blast transformation to nonspecific antigen – 38 (32–47) versus 50 (42–61) % (p=0.0004) (R=–0.37; p=0.0003).Conclusions. The development of acute coronary syndrome is directly combined with increased activity of the immune system, as evidenced by the high production of proinflammatory CRP, IL-8, sICAM with a low level of anti-inflammatory IL-10, a pronounced humoral adaptive immune response (in terms of antibodies to the myocardium and vascular tissues, CD40, circulating immune complexes) and active functional state of monocytes (according to cNCT test, functional reserve, phagocytosis) in patients with coronary artery disease with acute coronary syndrome, regardless of the position of the ST segment in comparison with patients with stable coronary artery disease. Elevated levels of antibodies to the myocardium in patients with stable coronary heart disease indicate moderate myocardial damage due to temporary ischemia in angina attacks, even with a stable course of the disease. In patients with acute coronary syndrome, high levels of antibodies to the myocardium indicate myocardial damage due to increased ischemia in plaque destabilization much earlier than the clinical manifestations of acute coronary syndrome. In acute coronary syndrome with ST-segment elevation, compared with ACS patients without ST-segment elevation, activation of neutrophils and suppression of the activity of adaptive T-cell immunity is noted (by the level of T-helpers, sCD40L, blast transformation of lymphocytes, γ-interferon in mononuclear cells, apoptosis of lymphocytes).

Relation of vascular dilator function and cardiac autonomic function with coronary angiography findings in patients with non-ST segment elevation acute coronary syndrome

2020 ◽  
pp. 204887262091871
Author(s):  
Gaetano Antonio Lanza ◽  
Eleonora Ruscio ◽  
Gessica Ingrasciotta ◽  
Tamara Felici ◽  
Monica Filice ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Cardiac Autonomic Function ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease

Background A sizeable number of patients with a diagnosis of non-ST segment elevation acute coronary syndrome show non-obstructive coronary artery disease. In this study we assessed whether differences in vascular and cardiac autonomic function exist between non-ST segment elevation acute coronary syndrome patients with obstructive or non-obstructive coronary artery disease. Methods and results Systemic endothelium-dependent and independent vascular dilator function (assessed by flow-mediated dilation and nitrate-mediated dilation of the brachial artery, respectively) and cardiac autonomic function (assessed by time-domain and frequency-domain heart rate variability parameters) were assessed on admission in 120 patients with a diagnosis of non-ST segment elevation acute coronary syndrome. Patients were divided into two groups according to coronary angiography findings: (a) 59 (49.2%) with obstructive coronary artery disease (≥50% stenosis in any epicardial arteries); (b) 61 (50.8%) with non-obstructive coronary artery disease. No significant differences between the two groups were found in both flow-mediated dilation (5.03 ± 2.6 vs. 5.40 ± 2.5%, respectively; P = 0.37) and nitrate-mediated dilatation (6.79 ± 2.8 vs. 7.30 ± 3.4%, respectively; P = 0.37). No significant differences were also observed between the two groups both in time-domain and frequency-domain heart rate variability variables, although the triangular index tended to be lower in obstructive coronary artery disease patients (30.2 ± 9.5 vs. 33.9 ± 11.6, respectively; P = 0.058). Neither vascular nor heart rate variability variables predicted the recurrence of angina, requiring emergency room admission or re-hospitalisation, during 11.3 months of follow-up. Conclusions Among patients admitted with a diagnosis of non-ST segment elevation acute coronary syndrome we found no significant differences in systemic vascular dilator function and cardiac autonomic function between those with obstructive coronary artery disease and those with non-obstructive coronary artery disease.

scholarly journals ST Segment Depression in 12 lead ECG and Severity of Coronary Artery Disease in Non-ST segment elevation Acute Coronary Syndrome

2017 ◽  
Vol 9 (2) ◽  
pp. 116-121
Author(s):  
Mohammad Emdadul Hoque Miah ◽  
Abul Hussain Khan Chowdhury ◽  
Khandaker Qamrul Islam ◽  
Mir Jamaluddin ◽  
Shakil Ghafur ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Positive Correlation ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease ◽  
Vessel Score

Background: Patients of non-ST segment elevation acute coronary syndrome (NSTE ACS) is a large group who gets admitted in coronary care units. 12-lead electrocardiogram (ECG) provides the simple available and earliest objective information for risk stratification of NSTEACS. We tried to find out the association between magnitude of ST segment depression and angiographic severity in NSTE ACS patients.Methods: This cross sectional study was carried out in patients with NSTE ACS patients admitted into and underwent coronary angiography. A total number of 105 consecutive patients were included in this study. ST segment depression was measured and categorized according to magnitude of ST segment depression into three groups as Group I: No (<1mm) ST segment depression, Group II: 1-2 mm ( e”1 to <2mm) ST segment depression and Group III: e” 2 mm ST segment depression. Cumulative sum of ST segment depression and number of leads in ST segment depression also measured in all ECG leads. Angiographic severity was assessed by vessel score and Friesinger index. Significant CAD was considered if Friesinger index was e” 5. Magnitude of ST segment depression was correlated with angiographic severity of coronary artery disease.Results: According to ‘Friesinger index’ 56(53.33%) patients had significant CAD and 49(46.66%) patients had insignificant CAD. Magnitude of ST segment depression found to have significant relationship with severity of coronary artery disease (p<0.001). Number of leads in ST segment depression also revealed positive correlation (r = 0.446; p<0.001). Positive correlation was also found between sum of the ST segment depression and Vessel score (r= 0.435; p<0.001).Conclusion: Magnitude of ST segment depression is positively correlated with the angiographic severity of coronary artery disease in non- ST segment elevation acute coronary syndrome.Cardiovasc. j. 2017; 9(2): 116-121

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