Schukina O. S.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Possibilities for predicting the course of non-st segment elevation acute coronary syndrome (NONST ACS) at the hospital stage are limited. Existing scales provide insufficient information on the prediction of clinical outcomes in patients with NON-ST ACS in the hospital phase. According to the latest recommendations of the European Society of Cardiology in 2020 additional laboratory biomarkers (highly sensitive C-reactive protein, regional pro-adrenomedulin, rupeptin) are not recommended for a routine use. Existing studies indicate that advanced glycation end products (AGEs) can be used as a new marker for short- and long-term prediction of coronary heart disease. The purpose of this study can be divided into identifying factors that affect the level of AGEs at the time of hospitalization in patients with NON-ST ACS, and study the possibility of predicting the hospital outcomes of NON-ST ACS by using AGEs. In addition to general clinical research methods, patients were examined by Holter ECG monitoring, determination of AGEs and ischemia-modified albumin on the 1st and 6th day of hospitalization. The study included patients with NON-ST ACS over the age of 18 who were hospitalized within the first three days of symptoms and signed the agreed to participate in the study. Patients with signs of other acute illnesses and / or decompensated chronic diseases were excluded. It was found that the level of AGEs does not depend on gender, hemodynamic parameters, ECG changes and the presence of acute left ventricular failure at the time of hospitalization. According to the results, patients older than 45 years tended to have a higher baseline AGEs level. Among the analyzed factors, an association between AGEs and low systolic blood pressure at the time of hospitalization was found. The study confirmed that elevated AGEs levels were associated with delayed ischemia in patients with NON-ST ACS. The delayed ischemia was confirmed by Holter ECG monitoring and elevated ischemiamodified albumin levels on 6th day of hospitalization.

acute coronary syndrome, advanced glycation end products, prognosis, hospital stage.

1. Berns SA, Shmidt EA, Klimenkova AV, Tumanova SA, Barbarash OL. Vozmozhnosti shkaly GRACE v dolgosrochnoy otsenke riska u bol’nykh s ostrym koronarnym sindromom bez pod`yema segmenta ST. Doctor.Ru. 2019;157(2):12-18. DOI: 10.31550/1727-2378-2019- 157-2-12-18. [in Russian].
2. Lou N. Routine use of risk score no better than usual care for heart attack patients – intervention did not improve guideline-recommended care [Internet]. MedPage Today, LLC; 2020. Available from https://www. medpagetoday.com/cardiology/acutecoronarysyndrome/90113.
3. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal. 2021 Apr 7;42(14):1289-1367. DOI: 10.1093/eurheartj/ehaa575.
4. Tkachenko VA, Skoromnaya AS, Muhammad M, ZabidaAbdunaser AM. Konechnyie produktyi glikirovaniya v norme i pri serdechno-sosudistoy patologii. Tezi dopovidey XI Mizhnarodnoyi konferentsiyi molodih uchenih Biologiya: vid molekuli do biosferi; 2016 Lyst 26 – Hrud 2; Kharkiv; 2016. s. 42-43. Dostupno: http://repo.dma.dp.ua/2325/1/tkachenko_tezy.pdf. [in Russian].
5. Titiv VN, Hohlova NV, Shiryaeva YK. Glyukoza, glikotoksiny i produkty glikirovaniya proteinov: rol’ v patogeneze. Klinicheskaya medicina [Internet]. 2013;3:15-24. Dostupno: https://cyberleninka.ru/article/n/ glyukoza-glikotoksiny-i-produkty-glikirovaniya-proteinov-rol-v-patogeneze/ viewer. [in Russian].
6. Shevtsova AI, Tkachenko VA. Konechnyye produkty glikirovaniya i ikh retseptory pri serdechno-sosudistykh zabolevaniyakh. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta [Internet]. 2019;17(1):11-16. Dostupno: http://journal-grsmu.by/index. php/ ojs/issue/ view/78. DOI: 10.25298/2221-8785-2019-17-1-11-16. [in Russian].
7. Zieman S, Kass D. Advanced glycation end product cross-linking: pathophysiologic role and therapeutic target in cardiovascular disease. Congest. Heart Fail. 2004;10:144-9. DOI: 10.1111/j.1527-5299.2004. 03223.x.
8. Kiuchi K. Increased serum concentrations of advanced glycation end products: a marker of coronary artery disease activity in type 2 diabetic patients. Heart [Internet]. 2001;85(1):87-91. Available from: . DOI: 10.1136/heart.85.1.87.
9. Qiu H, Li W, Shen X, Guo X, Hua B, Li H. Dynamic fluctuations of advanced glycation end products and its C-terminal truncated receptor level in patients with acute ST-segment elevation myocardial infarction and undergoing diabetes or not. Medicine. 2018;97(30):e11278. DOI: 10.1097/MD.0000000000011278.
10. Raposeiras-Roubín S, Rodiño-Janeiro B, Paradela-Dobarro B, Grigorian-Shamagian L, García-Acuña J, Aguiar-Souto P, et al. Fluorescent Advanced Glycation End Products and Their Soluble Receptor: The Birth of New Plasmatic Biomarkers for Risk Stratification of Acute Coronary Syndrome. PLoS ONE. 2013;8(9):e74302. DOI: 10.1371/journal.pone.0074302.

«Bulletin of problems biology and medicine» Issue 1 (163), 2022 year, 177-181 pages, index UDK 616.127

10.29254/2077-4214-2022-1-163-177-181