aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.15372/ATER20180203ateroskleroz-70Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESN-ТЕРМИНАЛЬНЫЙ ФРАГМЕНТ МОЗГОВОГО НАТРИЙУРЕТИЧЕСКОГО ПЕПТИДА И СТИМУЛИРУЮЩИЙ ФАКТОР РОСТА ST-2 У БОЛЬНЫХ ОСТРЫМ ИНФАРКТОМ МИОКАРДА В ЗАВИСИМОСТИ ОТ ФРАКЦИИ ВЫБРОСАN-TERMINAL PRO-BRAN OF NATRIURETHETIC PEPTIDE AND STIMULATING FACTOR OF GROWTH OF ST-2 IN PATIENTS WITH ACUTE MYOCARDIAL INFRACTION DEPENDING ON EMISSION FACTIONХоролецЕ. В.KhoroletsE. V.kata_maran@mail.ruФГБОУ ВО Ростовский государственный медицинский университет Минздрава РоссииРоссияRostov State Medical UniversatyRussian Federation2018270920191421824Copyright © Хоролец Е.В., 20192019Хоролец Е.В.Khorolets E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/70

Цель исследования - оценить маркеры прогноза сердечной недостаточности NTproBNP и ST-2 в динамике стационарного лечения пациентов с острым инфарктом миокарда с подъемом сегмента ST (ОИМпST) в зависимости от фракции выброса (ФВ). Материал и методы. Изучалась клиническая и лабораторная характеристика пациентов ОИМпST ( n = 150) в зависимости от ФВ левого желудочка (ЛЖ) <50 % и ФВ ³ 50 %. Оценивали уровень NTproBNP и ST-2 при госпитализации и выписке пациентов. По шкале GRACE рассчитывали прогноз госпитальной летальности больных ОИМпST. Результаты. Пациенты ОИМпST среднего возраста (61,7 ± 2,96 года) имели высокий риск летальности по шкале GRACE. В первые сутки заболевания выявлено повышение уровня NTproBNP и ST-2. У больных с ФВ < 50 % наблюдалось увеличение изучаемых показателей и маркеров некроза миокарда по сравнению с ФВ ³ 50 %. В динамике госпитального лечения у больных ОИМпST с ФВ < 50 % сохранялись высокие значения NTproBNP и ST-2; в отличие от пациентов с ФВ ³ 50 % установлено статистически значимое снижение NTproBNP и уменьшение ST-2 до нормальных значений. Заключение. Лабораторные показатели NTproBNP и ST-2 являются маркерами прогрессирования сердечной недостаточности у больных ОИМпST на госпитальном этапе лечения. У пациентов ОИМпST с ФВ < 50 % сохраняются высокие значения NTproBNP и ST-2 в течение всего стационарного лечения, определяя прогноз сердечной недостаточности.

The aim of the study was to evaluate the markers of the prognosis of heart failure NTproBNP and ST-2 in the dynamics of inpatient treatment of patients with acute myocardial infarction with ST segment elevation (STEMI), depending on the ejection fraction (EF). Materials and methods. Clinical and laboratory characteristics of patients with STEMI ( n = 150) were studied depending on left ventricular (LV) LV EF < 50 % and FV ³ 50 %. The level of NTproBNP and ST-2 was assessed during hospitalization and discharge of patients. The GRACE scale calculated the prognosis of hospital mortality of patients with STEMI. Results. Middle-aged STEMI patients 61.7 ± 2.96 years had a high risk of mortality on the GRACE scale. The first day of the disease revealed an increase in the level of NTproBNP and ST-2. Patients with EF <50 % showed an increase in the studied indicators and markers of myocardial necrosis in comparison with EF> 50 %. In the dynamics of hospital treatment in patients with STEMI with an EF <50 %, high values of NTproBNP and ST-2 persisted; in contrast to patients with EF ³ 50 % a statistically significant decrease in NTproBNP and a decrease in ST-2 to normal values were established. Conclusion Laboratory indicators NTproBNP and ST-2 are markers of progression of heart failure in patients with STEMI at the hospital stage of treatment. In patients with STEMI with an EF <50 %, high values of NTproBNP and ST-2 persist throughout the in-patient treatment, determining the prognosis of heart failure.

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