Examination of inflammatory markers pentraxin 3, cyclophilin A and heparin-binding epidermal growth factor in patients with acute myocardial infarction with ST-elevation

Abstract

Poznato je da je koronarna arterijska bolest (KAB) povezana sa inflamatornim i oksidativnimprocesima koji dovode do okluzije koronarnih arterija i akutnog koronarnog sindroma, najčešćeinfarkta miokarda sa ST-elevacijom (STEMI). Još uvek se traga za biomarkerima koji bi bili korisni uklasifikaciji bolesnika prema težini bolesti i u predviđanju budućih srčanih događaja. Svrha ove studijeje da se ispitaju koncentracije pentraksina 3 (PTX3), ciklofilina A (CyPA) i heparin-vezujućegepidermalnog faktora rasta (HB-EGF) kod bolesnika sa STEMI (N=87) u odnosu na zdrave osobe(N=193) i bolesnike sa stabilnom anginom pektoris (N=15) kako bi se utvrdilo da li su promene ovihparametara posledica hronične srčane bolesti ili im se vrednosti menjaju usled akutnih poremećaja uSTEMI. Dodatno je analizirano da li primena primarne perkutane koronarne intervencije (pPCI) dovodido oštećenja krvnih sudova srca što će se manifestovati kroz promenu u koncentracijama navedenihispitivanih parametara. Ovi parametri su analizirani i kod bolesnika sa dijagnozom infarkta miokardabez opstrukcije koronarnih arterija (MINOCA). Studija je pokazala da su inflamatorni biomarkeriPTX3 i HB-EGF povišeni u STEMI i da se značajno menjaju posle pPCI kod bolesnika saopstruktivnom KAB u poređenju sa vrednostima pre procedure. MINOCA bolesnici imali su značajnoviše vrednosti PTX3 u odnosu na bolesnike sa STEMI. Kako bi se ispitali nezavisni prediktori visokihkoncentracija PTX3 i HB-EGF kod bolesnika sa STEMI, primenjena je faktorska analiza. Faktormetaboličko-oksidativnog stresa je značajan prediktor visokih koncentracija PTX3, dok je PTX3značajan prediktor visokih koncentracija HB-EGF. Osim toga, rezultati su pokazali da je identifikacijaMINOCA etiologije ključna za lečenje ovih bolesnika u čemu, pored standardnih procedura, možepomoći određivanje koncentracije PTX3.Since the association of coronary artery disease (CAD) with inflammatory and oxidativeprocesses that leads to the development of coronary artery occlusion and acute coronary syndrome,most commonly in the form of ST-elevation myocardial infarction (STEMI) have been recognized,biomarkers that would be useful in classifying patients according to disease severity and in predictingfuture cardiac events are still being sought. This study aimed to examine the concentrations ofpentraxin 3 (PTX3), cyclophilin A (CyPA) and heparin-binding epidermal growth factor-like growthfactor (HB-EGF) in patients with STEMI (N = 87) compared to healthy subjects (N = 193) and patientswith stable angina pectoris (N = 15) to determine whether changes in these parameters are due tochronic heart disease or their values change due to acute disorders in STEMI. It was additionallyanalyzed whether the application of primary percutaneous coronary intervention (pPCI) leads todamage of the heart blood vessels, which will be manifested as a change in the concentrations of theexamined parameters. These parameters were also analyzed in patients with the diagnosis of themyocardial infarction without coronary artery obstruction (MINOCA). This study showed that theinflammatory biomarkers PTX3 and HB-EGF are elevated in STEMI and change significantly afterpPCI in patients with obstructive CAD compared to pre-procedure values. MINOCA patients hadsignificantly higher PTX3 values compared to patients with STEMI. Factor analysis was applied toexamine independent predictors of high PTX3 and HB-EGF concentrations in patients with STEMI.The metabolic-oxidative stress factor is a significant predictor of high concentrations of PTX3, whilePTX3 is a significant predictor of high concentrations of HB-EGF. Besides, the results showed that theidentification of MINOCA etiology is crucial for the treatment of these patients in which thedetermination of PTX3 concentration can help, in addition to standard procedures