Inflammation indicators and leptin level in patients with ischemic heart disease

Abstract

Background: The pathogenic bases of destabilizing the flow of ischemic heart disease are not studies well enough. Aim: to study the plasma concentration and interrelation of inflammation biomarkers of C-reactive protein, tumor-necrotic factor-α and leptin level in patients with ischemic heart disease of different nature of flow and to define their diagnostic value as of indicators for destabilizing the atherosclerotic process. Patients and methods: 86 male patients with ischemic heart disease of the average age of 56.2±5.1 have been examined. 29 patients showed stable ischemic heart disease of functional class II, 31 patients - ischemic heart disease of functional class III, while 26 patients were diagnosed with unstable ischemic heart disease. The control group included 26 practically healthy men of matching age who volunteered to participate. All the patients were examined according to the Guidelines of the European Society of Cardiologists (ESC, 2013). The plasma concentrations of highly sensitive C-reactive protein, tumor- -necrotic factor-α and leptin were determined by immune-enzyme methods. The statistical analysis was made with the help of software kits Microsoft Excel, Statistica for Windows 6.0. Results: the patients with ischemic heart disease the levels of the studied indices tended to grow and were higher in comparison with reference values, the most visible changes being detected in patients with unstable angina. The destabilized process showed the valid increase of the levels of highly sensitive C-reactive protein and tumor-necrotic factor-α in 92.3 % and 100% patients, leptin level - in 84.6 % patients correspondingly. The critical limit values allowing to suggest the activation of latent inflammation irrespective of presence or absence of clinical symptoms were identified. To them refer the levels of plasmatic highly sensitive C-reactive protein - 2.57 mg/ml, tumor-necrotic factor-α - 2.44 pg/ml, leptin - 18.44 ng/mL. The information value and capability of destabilization model of ischemic heart disease significantly rose at simultaneous use of such two markers of non-specific inflammation as C-reactive protein and tumor-necrotic factor-α. Adding leptin to the mathematic model did not show any significant impact on its information capacity. Conclusions: identifying combinations of levels of highly sensitive C-reactive protein >2.97 mg/L and tumor-necrotic factor-α >2.44 pg/ml possesses maximal prognostic capacity with regard to atherosclerosis destabilization and development of cardiovascular complications in patients with stable ischemic heart disease.