Clinical and pathogenetic significance of adhesion molecules in case of acute coronary syndrome in young patients


DOI: https://dx.doi.org/10.18565/therapy.2024.10.52-58

Gladkikh N.N., Eremenko A.M., Yagoda A.V.

Stavropol State Medical University of the Ministry of Healthcare of Russia
Abstract. Diagnostic significance of adhesion molecules in case of acute coronary syndrome (ACS) in young patients has not been sufficiently studied. However, estimation of the endothelial adhesive function in this category of patients may be useful for obtaining additional markers of inflammatory and thrombotic risks.
The aim: to determine the peculiarities of the pathogenetic development of coronary heart disease (CHD) acute forms in young patients, taking into account adhesion molecules indexes in the blood.
Material and methods. 100 patients with ACS aged 25–44 years were examined. All patients underwent stenting of the symptom-related artery. On the 1st and 7th days of hospital admission, the levels of E-, L-, P-selectins, ICAM-1 and VCAM-1 in the blood were assessed (CloudClone Corp., China).
Results and discussion. In young patients with ACS, elevated concentrations of P-selectin and ICAM-1 were detected on the 1st and 7th days, as well as VCAM-1 on the 7th day of the disease. Maximum increase of ICAM-1 level by the 7th day was recorded in cases of ACS with ST-segment elevation (p = 0.001) or with its transformation into Q-positive myocardial infarction (p = 0.004). Cases of increase of L-selectin in dynamics were fixed in cases of Q-positive myocardial infarction (p = 0.036) and single-vessel coronary disease (p = 0.023). Patients with unstable angina pectoris were characterized by a significant decrease in P-selectin by the 7th day of the disease (p = 0.004). Increased concentrations of adhesion molecules on the 7th day of the disease indicate prolonged activation of vascular inflammation. Dynamic changes in the levels of ICAM-1, L- and P-selectins associated with various clinical variants of ACS reflect the pathogenetic special features of acute forms of CHD and can serve as a basis for new approaches to treatment.
Conclusion. P-selectin, ICAM-1 and VCAM-1 can be used as additional markers of the intensity of the inflammatory process and endothelial dysfunction in young patients with ACS. Peculiarities of dynamic changes of ICAM-1, L- and P-selectins are associated with various forms of ACS and variants of its transformation.
Keywords: diagnostics of ischemic heart disease, adhesion molecules, young age, acute coronary syndrome
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About the Autors

Natalya N. Gladkikh, MD, Dr. Sci. (Medicine), professor, professor of the Department of hospital therapy, Stavropol State Medical University of the Ministry of Healthcare of Russia. Address: 355017, Stavropol, 310 Mira St.
E-mail: ngladkih@mail.ru
ORCID: https://orcid.org/0000-0003-4510-3604
Alexey M. Eremenko, MD, assistant at the Department of hospital therapy, Stavropol State Medical University of the Ministry of Healthcare of Russia. Address: 355017, Stavropol, 310 Mira St.
E-mail: eremenko.alexey@bk.ru
ORCID: https://orcid.org/0009-0005-4985-8862
Alexander V. Yagoda, MD, Dr. Sci. (Medicine), professor, Honored Scientist of the Russian Federation, head of the Department of hospital, Stavropol State Medical University of the Ministry of Healthcare of Russia. Address: 355017, Stavropol, 310 Mira St.
E-mail: alexander.yagoda@gmail.com
ORCID: https://orcid.org/0000-0002-5727-1640


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