BIOCHEMICAL MARKERS OF INFLAMMATION IN PATIENTS WITH ACUTE CORONARY SYNDROME

Aim of the study was to reveal differential features of inflammatory response markers in myocardial infarction (MI) compared to unstable angina (UA) and to determine activation of which inflammatory biochemical markers accompanies cardiomyocyte damage at early stage of necrosis development in patients with MI.

Materials and methods. A total of 279 patients with acute coronary syndrome (ACS) included in the database of percutaneous coronary interventions in 2012-2013 were examined. Group 1 included 69 patients with UA, group 2 consisted of 210 patients with MI. Biochemical markers of inflammation and myocardial injury were determined upon admission to the hospital, in order to clarify the nature of the relationship between them an automated artificial neural network (ANN) was constructed.

Results. Patients with MI compared to UA patients had higher serum levels of troponin-T (0,71 [0.10; 2.00] and 0.00 [0.00; 0.00] ng/ml, respectively, p < 0.01) and creatine phosphokinase MB isoenzyme (CPK-MB) (70,7 [31.2; 159.6] and 20.1 [11.6; 29.7] u/l, respectively, p < 0.001) as well as C-reactive protein (CRP) (6.20 [2.01; 10.22] and 3.40 [0.86; 6.03] mg/l, respectively, p < 0.001) and homocysteine (15.4 [12.2; 18.3] and 13.8 [10.4;16.4] μmol/l, respectively, p = 0.028); data are presented as: median [lower quartile; upper quartile]. Later, the ANN model (multilayer perceptron) was obtained with an input layer consisting of three neurons representing the following serum biochemical parameters: CPK-MB, homocysteine and CRP concentration. The greatest predictive value for the confirmation of myocardial injury were homocysteine and CRP content.

Conclusions. Patients with MI and UA did not differ in cytokine level. According to the obtained ANN model, homocysteine activation as a marker of systemic inflammation and CRP as a marker of local inflammatory response accompany cardiomyocyte damage at early stages of necrosis development in patients with MI.

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