BIOMARKERS FOR ASSESSING CARDIOVASCULAR COMPLICATIONS RISK FOLLOWING CORONARY ARTERY STENTING
Objective. To assess the possibility of using MMP-9, PAI-1, sICAM, Tgf-b1 as laboratory markers for the cardiovascular complications development in the early terms (the first day) after stenting.
Materials and methods. The biochemical markers levels were determined in the blood serum taken in 102 patients within 24 hours after stenting. Morphological studies were conducted on 136 segments of the coronary arteries taken in 21 persons having died after acute myocardial infarction within 24 hours after stenting. An enzyme immunoassay (ELISA) was performed to examine the blood levels of biochemical markers. The absorbance was measured on an enzyme immunoassay analyzer «SIRIOS SEAC» (Italy). In order to analyze and evaluate the processes of the extracellular matrix restructuring in the coronary arteries after the stenting, the biomolecular markers MMP-9, Tgf-b1, sICAM, and PAI-1 expression were quantified.
Results. It was found that the MMP-9, Tgf-b1 concentrations increased and the sICAM and PAI-1 decreased statistically significantly (p<0.05) in the blood serum of patients with acute myocardial infarction in comparison with the healthy ones’ values. The MMP-9, Tgf-b1, concentrations increase and decrease sICAM in the blood serum of patients with acute myocardial infarction was not associated with the MMP-9, Tgf-b1, and sICAM expression in the coronary artery tissue on the first day after stenting. The MMP-9 and sICAM-1 activation in the coronary artery tissue at the early stages after stenting indicated to the tissue damage, inflammation and thrombosis development. The Tgf-b1 overexpression in the coronary artery tissue at an early stage after the surgery might stimulate the fibrosis and restenosis development. Reduction of the PAI-1 concentration in the blood serum of patients with acute myocardial infarction was associated with the PAI-1expression increase in coronary artery tissue on the first day after the stenting (r=–0.36; р<0.05) and might be considered an аcute thrombosis predictor.