Dynamics of immunological indicators of blood in patients with chronic coronary artery disease in comparison with the development of cardiovascular episodes during long-term follow-up
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Abstract
The aim – to assess the relationship between the dynamics of immunological and blood lipoproteid indicators in patients with chronic coronary artery disease and the development of cardiovascular episodes compared to patients with coronary artery disease without such episodes during 6.5 years of observation.
Materials and methods. Patients with coronary artery disease with stable angina pectoris were divided into two groups: the first group (n=46) included patients without cardiovascular events during the observation period, the second group (n=36) included patients with the occurrence of such events within 6.5 years of observation. The material of 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. Comparison of the dynamics of T-cell immunity: in the second and first groups, the dynamics of medians of T-suppressors (CD8) – from 22 to 33 (p=0.018) versus 27 to 33 % (p=0.10), the number of lymphocytes with a tendency to apoptosis in the second and first groups it was equal – from 18 to 27 (p=0.11) versus from 12 to 29 % (p=0.002). Between patients with the development of cardiovascular events compared with patients without them, the dynamics of median CRP, respectively, was from 6.7 to 7.8 (p=0.043) versus 3.2 to 3.8 mg/l (p=0.024), IL-6 in mononuclear cells – from 2239 to 5788 (p=0.47) vs. 2127 to 5544 pg/ml (p=0.005), IL-8 in mononuclear cells – from 2305 to 3536 (p=0.028) vs. from 1980 to 3820 pg/ml (p=0.0004), anti-inflammatory IL-10 in mononuclear cells – from 95 to 44 (p=0.69) vs. 220 to 68 pg/ml (p=0.97). Between patients of the second group, compared with the first, the dynamics of median levels of total cholesterol compared, respectively, from 6.9 to 6.0 (p=0.07) versus 5.9 to 6.5 mmol / l (p=0.15), triglycerides (TG) – from 2.2 to 1.1 (p=0.08) vs. 1.9 to 1.5 mmol/l (p=0.030), HDL cholesterol – from 1.15 to 1.28 (p=0.89) versus 1.10 to 1.40 mmol/l (p=0.0005), the dynamics of the median degree of peroxide modification of lipoproteins was from 7.1 to 2.6 (p=0.14) versus from 5.4 up to 3.1 conventional units (p=0.0008), free radical oxidation of proteins – from 3.3 to 5.0 (p=0.028) compared with 4.6 to 5.1 conventional units. (p=0.54).
Conclusions. In patients with stable coronary artery disease, the activity of immune inflammation significantly increases for 6.5 years. The development of cardiovascular events is not accompanied by the peculiarities of the growth of immune inflammation indicators, the peculiarities of changes in the studied parameters of the humoral link of acquired immunity and the parameters of the phagocyte system in comparison with patients without such events. The occurrence of cardiovascular events is accompanied by greater activation of T-lymphocytes and a lower increase in the number of lymphocytes with a predisposition to apoptosis, a significant increase in free radical oxidation of proteins during this period compared to patients without such complications. The absence of the development of cardiovascular events is combined with a significant increase in HDL cholesterol during statin therapy.
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Бебешко В.Г., Чумак А.А., Базыка Д.А., Беляева Н.В. Моноклональные антитела в радиационной иммунологии: Методические рекомендации. Киев, 1993.19 с.
Дубинина Е.Е., Бурмистров С.О., Ходов Д.А., Порогов И.Г. Окислительная модификация белков сыворотки крови человека, метод ее определения. Вопросы мед. химии. 1995. Т. 41. С. 24-26.
Применение проточной цитометрии для оценки функциональной активности иммунной системы человека: Пособие для врачей – лаборантов. М., 2001. – 53 с.
Стандартизация методов иммунофенотипирования клеток крови и костного мозга человека (рекомендации рабочей группы СПб РО РААКИ). Мед. Иммунология. 1999. т. 5. № 1. С. 21-43.
Стефани Д.Ф., Вельтищев Ю.Е. Клиническая иммунология и иммунопатология детского возраста. М.: Медицина, 1996. 372 с.
Унифицированные иммунологические методы обследования больных на стационарном и амбулаторном этапах лечения: Метод. рекомендации. Киевский НИИ фтизиатрии и пульмонологии. Киев, 1988. 18 с.
Blaha MJ, Cainzos-Achirica M, Greenland P, et al. Role of Coronary Artery Calcium Score of Zero and Other Negative Risk Markers for Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis (MESA). CLINICAL PERSPECTIVE Circulation. 2016;133(9):849-58. doi: https://doi.org/10.1161/CIRCULATIONAHA.115.018524.
C Reactive Protein Coronary Heart Disease Genetics Collaboration (CCGC). Association between C reactive protein and coronary heart disease: mendelian randomisation analysis based on individual participant data. BMJ. 2011;342(15):d548. doi: https://doi.org/10.1136/bmj.d548 (Published 15 February 2011)
Cavusoglu E, Marmur JD, Yanamadala S, et al. Elevated baseline plasma IL8 levels are an independent predictor of longterm allcause mortality in patients with acute coronary syndrome. Atherosclerosis. 2015;242(2):589-94. https://doi.org/10.1016/j.atherosclerosis.2015.08.022
Cheng JM, Oemrawsingh RM, Garcia-Garcia HM, et al. Relation of C-Reactive Protein to Coronary Plaque Characteristics on Grayscale, Radiofrequency Intravascular Ultrasound, and Cardiovascular Outcome in Patients With Acute Coronary Syndrome or Stable Angina Pectoris (from the ATHEROREMO-IVUS Study). Amer J Cardiol. 2014;114(10):1497-503. https://doi.org/10.1016/j.amjcard.2014.08.013.
Gergei I, Kälsch Th, Scharnagl H, Kleber ME. Association of soluble CD40L with short-term and long-term cardiovascular and all-cause mortality: The Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Atherosclerosis. 2019;291:27-131. doi: https://doi.org/10.1016/j.atherosclerosis.2019.09.004.
Kosmidou I, Redfors B, Chen S, et al. C-reactive protein and prognosis after percutaneous coronary intervention and bypass graft surgery for left main coronary artery disease: Analysis from the EXCEL trial. AHJ. 2019;210:49-https://doi.org/57.10.1016/j.ahj.2018.12.013.
Landman GWD, Kleefstra N, Groenier KH, et al. Inflammation biomarkers and mortality prediction in patients with type 2 diabetes (ZODIAC-27). Atherosclerosis. 2016;250:46-51. https://doi.org/10.1016/j.atherosclerosis.2016.04.015.
Nafari A, Mohammadifard N, Haghighatdoost F, et al. High-sensitivity C-reactive protein and low-density lipoprotein cholesterol association with incident of cardiovascular events: Isfahan cohort study. BMC Cardiovascular Disorders. 2022;22(1) https://doi.org/10.1186/s12872-022-02663-0.
Oikawa T, Sakata Y, Nochioka K, et al. Association between temporal changes in C-reactive protein levels and prognosis in patients with previous myocardial infarction – A report from the CHART-2 Study. Int J Cardiol. 2019;293:17-24. https://doi.org/10.1016/j.ijcard.2019.07.022.
Park M, Kulkarni A, Beatty A, et al. Soluble endothelial cell selective adhesion molecule and cardiovascular outcomes in patients with stable coronary disease: A report from the Heart and Soul Study. Atherosclerosis. 2015;243(2):546-52. https://doi.org/10.1016/j.atherosclerosis.2015.10.092.
Park M, Maristany D, Huang D, et al. Associations of tumor necrosis factor alpha receptor type 1 with kidney function decline, cardiovascular events, and mortality risk in persons with coronary artery disease: Data from the Heart and Soul Study. Atherosclerosis. 2017;263:68-73. https://doi.org/10.1016/j.atherosclerosis.2017.05.021.
Parrinello CM, Lutsey PL, Ballantyne CM, et al. Six-year change in high-sensitivity C-reactive protein and risk of diabetes, cardiovascular disease, and mortality. AHJ. 2015;170(2):380-9. https://doi.org/10.1016/j.ahj.2015.04.017
Penson PE, Long DL, Howard G, et al. Associations between very low concentrations of low density lipoprotein cholesterol, high sensitivity C-reactive protein, and health outcomes in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study. Eur Heart J. 2018;39(40):3641-53. https://doi.org//10.1093/eurheartj/ehy533.
Ridker PM. Targeting inflammatory pathways for the treatment of cardiovascular disease. Eur. Heart J. 2014;35(9):540-3. https://doi.org/10.1093/eurheartj/eht398
Sager HB, Heidt T, Hulsmans M, et al. Targeting Interleukin-1β Reduces Leukocyte Production After Acute Myocardial Infarction. CLINICAL PERSPECTIVE. Circulation. 2015;132:1880-90. https://doi.org/10.1161/CIRCULATIONAHA.115.016160.
Shah N, Parikh V, Patel N, et al. Neutrophil lymphocyte ratio significantly improves the Framingham risk score in prediction of coronary heart disease mortality: Insights from the National Health and Nutrition Examination Survey-III. Int J Cardiol. 2014;171(3):390-7. https://doi.org/10.1016/j.ijcard.2013.12.019.
Tuñón J, Blanco-Colio L, Cristóbal C, Tarín N. Usefulness of a Combination of Monocyte Chemoattractant Protein-1, Galectin-3, and N-Terminal Probrain Natriuretic Peptide to Predict Cardiovascular Events in Patients With Coronary Artery Disease. Amer J Cardiol. 2014;113(3):434-40. https://doi.org/10.1016/j.amjcard.2013.10.012.
Velásquez IM, Frumento P, Johansson K, et al. Association of interleukin 8 with myocardial infarction: Results from the Stockholm Heart Epidemiology Program. Int J Cardiol. 2014;172(1):173-8. https://doi.org/10.1016/j.ijcard.2013.12.170.
Woo JS, Kim W, Jang HH, Kim JB. Effect of Platelet Reactivity, Endothelial Function, and Inflammatory Status on Outcomes in Patients With Stable Angina Pectoris on Clopidogrel Therapy. Amer J Cardiol. 2014;113(5):786–92. https://doi.org/10.1016/j.amjcard.2013.11.025.