Endothelin-1 (E-1) is the most informative marker of inflammation of the vessel wall. It causes the expression of adhesion molecules that stimulate the migration of leukocytes to the subendothelium. Ratio apoB/apoA1 reflects balance of cholesterol transport. Increased apoB/apoA1 indicates the deposition of cholesterol in the vessel wall and the progression of atherosclerosis.
The purpose of our work was to study the peripheral blood level of E-1 in patients with acute myocardial infarction with ST segment elevation (AMI ↑ ST) and its relationship with expression of adhesion molecules (ICAM-1) and the concentration of atherogenic lipoproteins.
Methods. The study involved 45 patients with AMI ↑ ST (age from 35 to 65) in which concentrations of E-1, ICAM-1, and apoB/apoA1 ratio in peripheral blood was assessed on the admission to hospital.
Results. Levels of E-1 in the examined patients was significantly (at 7.31 times, p <0.0001) higher than in the control group (12 health persons) and were 0,256 ± 0,084 and 0,035 ± 0,015 ng/ml, respectively. The highest E-1 values were in patients with complications (life-threatening arrhythmia, acute left ventricular failure Killip III-IV), reaching 0,336-0,029 ng/ml.
Analysis of ICAM-1 levels showed a significant (p ≤ 0,05) increased values to 379,30 ± 17,24 ng/ml, as compare with those in the control group (215,52 ± 17,54 ng/ml). ApoB in examined patients shown to be elevated - 1,52 ± 0,07 g/l in contrast to control (1,18 ± 0,09 g/l). Parameters of apoA1 in studied patients were lower as compare with health individuals (1,15 ± 0,06 g/l and 1,57 ± 0,17 g/l, respectively, p ≤ 0,05). Significantly elevated by 74.67% was apoB/apoA1 ratio in the examined patients - 1,32 ± 0,05 g/l, compared with the control - 0,75 ± 0,07 g/l, p ≤ 0,05.
Complications were observed in most patients (83%) with the highest tertiles of ICAM-1 and apoB levels.
Significant correlation was founded between the ICAM-1 and the apoB/apoA1 ratio - r = 0,41, p = 0.01, and E-1 and ICAM-1- r = 0,83, p ≤ 0,001.
Conclusion. The onset of AMI is accompanied by a significant increasing of E-1 level and ICAM-1 expression, indicating a deepening of endothelial dysfunction and intensification of activity of systemic inflammation, which is directly linked to the destabilization of atherosclerotic plaques. The simultaneous increasing of atherogenic apoB indicates its leading position not only in the formation of atherosclerotic plaques, but also in their instability. Determination of E -1 and ICAM-1 concentration and apoB/apoA1 ratio in AMI ↑ ST onset is appropriate for predicting its complicated course.