aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.15372/ATER20170403ateroskleroz-56Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПОКАЗАТЕЛИ NT-PROBNP И ST-2 У ПАЦИЕНТОВ С ОСТРЫМ ИНФАРКТОМ МИОКАРДА С ПОДЪЕМОМ СЕГМЕНТА STINDICATORS NT-PROBNP and ST-2 IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH ST-SEGMENT ELEVATIONХоролецЕ. В.KhoroletsE. V.kata_maran@mail.ruХаишеваЛ. А.KhaishevaL. A.noemail@neicon.ruШлыкС. В.ShlykS. V.sshlyk@mail.ruФГБОУ ВО Ростовский государственный медицинский университет Минздрава РоссииRostov State Medical University of Minzdrav of Russia2017270920191341724Copyright © Хоролец Е.В., Хаишева Л.А., Шлык С.В., 20192019Хоролец Е.В., Хаишева Л.А., Шлык С.В.Khorolets E.V., Khaisheva L.A., Shlyk S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/56

Цель исследования - изучить клинические особенности, показатели NTproBNP и ST-2 у пациентов с острым инфарктом миокарда с подъемом сегмента ST (ОИМпST), осложненного сердечной недостаточностью. Материал и методы. Включено 150 пациентов ОИМпST в первые 24 часа заболевания с артериальной гипертонией, острой сердечной недостаточностью (ОСН) Killip II-IV степени. Изучались особенности ОИМпST в зависимости от степени тяжести ОСН, уровня ST-2 ≥ 35 и ST-2 < 35 нг/мл. Всем пациентам проводилось клиническое, лабораторное и инструментальное обследование при поступлении в стационар (первый визит) и выписки (второй визит). Результаты. Средний возраст пациентов составил 61,70 ± 2,96 года. В динамике стационарного лечения больных ОИМпST общей группы выявлено снижение уровня ST-2 на фоне высокой концентрации NTproBNP. При прогрессировании степени ОСН Killip II-IV уровень ST-2 и NTproBNP увеличивается. На первом визите в группе больных ST-2 ≥ 35 нг/мл уровень ST-2 и NTproBNP статистически выше, чем у пациентов группы ST-2 < 35 нг/мл. На втором визите в группе ST-2 ≥ 35 нг/мл выявлено снижение уровня ST-2, а значения NTproBNP сохраняются высокими в изучаемых группах. Установлено статистически значимое снижение фракции выброса у пациентов с ST-2 ≥ 35 нг/мл по сравнению с группой больных ST-2 < 35 нг/мл. Заключение. У пациентов ОИМпST показатели ST-2 и NTproBNP являются прогностическими маркерами прогрессирования ОСН. Больные с уровнем ST-2 ≥ 35 нг/мл имеют наиболее неблагоприятный прогноз развития СН. В динамике стационарного лечения уровень ST-2 снижается, но превышает клинически значимый порог 35 нг/мл.

The goal was to study clinical features, NTproBNP and ST-2 indices in patients with acute myocardial infarction with ST segment elevation (STEMI) complicated by heart failure. Materials and methods. Included 150 patients with STEMI in the first 24 hours from the onset of the disease, with arterial hypertension, acute heart failure (AHF), Killip I-IV degree. All patients underwent clinical, laboratory and instrumental examinations: on admission to the hospital (first visit) and discharge (second visit). Results. The average age of the patients was 61.70 ± 2.96 years. In the dynamics of treatment of STEMI patients in the general group, a decrease in the level of ST-2 was observed against a background of high concentration of NTproBNP. With the progression of the degree of AHF Killip II-IV, the level of ST-2 and NTproBNP increases. At the first visit in the ST-2 ≥ 35 ng/mL group, the ST-2 and NTproBNP levels were statistically higher than those in the ST-2 group <35 ng/ml. At the second visit in ST-2 ≥ 35 ng/ml group, ST-2 level was decreased, and NTproBNP values remained high in the studied groups. A statistically significant reduction in the ejection fraction in patients with ST-2 ≥ 35 ng/ml was found to be statistically significant compared to the ST-2 group <35 ng/ml. The conclusion. In STEMI patients, ST-2 and NTproBNP are prognostic markers for the progression of acute heart failure. In the dynamics of inpatient treatment, the level of ST-2 persisted more than 35 ng/ml, in the ST-2 group of 35 ng/ml has the most unfavorable prognosis of heart failure.

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The authors declare that there are no conflicts of interest present.