Clinical and prognostic value of the skin autofluorescence parameter in coronary heart disease and peripheral arterial disease patients


DOI: https://dx.doi.org/10.18565/therapy.2024.2.32-40

Davydova N.A., Lebedev P.A., Chernyshev A.V., Kornilin D.V., Grishanov V.N., Komarova M.V.

1) Samara State Medical University of the Ministry of Healthcare of Russia; 2) V.D. Seredavin Samara Regional Clinical Hospital; 3) Academician S.P. Korolev Samara National Research University
Abstract. Determining the prognosis in patients with a wide range of atherosclerosis clinical manifestations is quite difficult and requires integral parameters, which may include the same as skin autofluorescence (SAF) parameter.
The aim: to establish the prognostic significance of non-invasively determined SAF as a factor of cardiovascular complications and mortality.
Material and methods. Prospective study included 122 male patients hospitalized with peripheral arterial disease (PAD) and 31 male patients with acute coronary syndrome diagnosis. Clinical, anthropometric, biochemical, as well as instrumental parameters of heart and blood vessels were studied using methods of ultrasound investigation. To determine SAF, we used an original device developed by the authors. Control group consisted of 35 practically healthy male patients. The prospective part of the study was performed for up to 1043 days (average 736 days).
Results. SAF values did not differ in the main study groups, but were significantly higher than those in the control group (p < 0.001). SAF positively and significantly correlated with scores on the scale of clinical prognostic signs with chronic arterial insufficiency, the fact of previous operations on the arteries of lower extremities and Syntax coronary stenosis index. During observation period, 7 deaths and at least one hospitalization for cardiovascular reasons in 58 patients took place. Use of logistic and Cox regression methods in the group of PAD patients made it possible to establish that hospitalization or mortality was associated with SAF and plasma glucose, and also with the presence of chronic heart failure above functional class 1. The parameters of the constructed ROC-curve were as following: AUC = 0.73 (sensitivity 71%, specificity 68%). The use of a combined group of patients with coronary heart disease (n = 139) as a test sample was characterized by acceptable model quality: AUC = 0.75.
Conclusion. SAF parameter reflects the processes of remodeling of the cardiovascular system and can be used as an integral independent predictor of complications in patients with different clinical forms of atherosclerosis.
Keywords: skin autofluorescence, peripheral atherosclerosis, coronary heart disease, cardiovascular risk, prognosis
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About the Autors

Nailya A. Davydova, MD, postgraduate student of the Department of therapy at the Institute of professional education with a course in functional diagnostics, Samara State Medical University of the Ministry of Healthcare of Russia, cardiologist. Address: 443099, Samara, 89 Chapaevskaya St.
E-mail: nelya999@mail.ru
ORCID: https://orcid.org/0000-0003-1956-3690
Petr A. Lebedev, MD, Dr. Sci. (Medicine), professor, head of the Department of therapy at the Institute of professional education with a course in functional diagnostics, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya St.
Email: palebedev@yahoo.com
ORCID: https://orcid.org/0000-0003-1404-7099
Alexey V. Chernyshev, MD, head of the Department of cardiology, V.D. Seredavin Samara Regional Clinical Hospital. Address: 443095, Samara, 159 Tashkentskaya St.
E-mail: avchern70@mail.ru
ORCID: https://orcid.org/0000-0002-9040-9576
Dmitry V. Kornilin, MD, PhD (Tech.), professor of the Department of laser and biotechnical systems, Academician S.P. Korolev Samara National Research University, PhD. Address: 443086, Samara, 34 Moskovskoe Highway.
E-mail: kornilin@mail.ru
ORCID: https://orcid.org/0000-0002-0694-4016
Vladimir N. Grishanov, MD, PhD (Tech.), associate professor, associate professor of the Department of laser and biotechnical systems, Academician S.P. Korolev Samara National Research University. Address: 443086, Samara, 34 Moskovskoe Highway.
E-mail: vladgrishanov@yandex.ru
ORCID: https://orcid.org/0000-0002-6675-4396
Marina V. Komarova, MD, PhD (Biol.), associate professor, associate professor of the Department of laser and biotechnical systems, Academician S.P. Korolev Samara National Research University. Address: 443086, Samara, 34 Moskovskoe Highway.
E-mail: komarova.mv@ssau.ru
ORCID: https://orcid.org/0000-0001-6545


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