Growth factors and lesions: prognostic value in acute coronary syndrome

Objective. The objective of this study is to conduct comparative analysis of levels of pregnancy-associated plasma protein (PAPP-A) and insulin-like growth factor 1 (IGF-I) in blood plasma from patients with acute coronary syndrome (ACS). It is also to confirm the biological role of PAPP-A and IGF-I as interacting components of intravascular damage and atherosclerotic plaque repair, and to estimate clinical significance of PAPP-A and IGF-I in patients with ACS. Materials and Methods. Concentrations of PAPP-A and IGF-I were determined in 71 patients with ACS. The median age of patients enrolled in clinical trials was 57 years. Within 24 hours 44 patients of the study group were diagnosed with acute myocardial infarction, 27 patients with unstable angina. Besides, 9 fatal cases were reported. At the same time concentrations of PAPP-A and IGF-I were determined in experimental and control groups. The comparison group consisted of 40 patients with essential hypertension and stable ischemic heart disease. The control group included 20 apparently healthy people. Results and Discussion. Concentrations of PAPP-A and IGF-I in patients with acute coronary syndromes differ from those in patients of experimental and control groups. PAPP-A in patients with unstable angina 3.56 times exceeds the values in control group, and in patients with myocardial infarction - 11,6 times. PAPP-A in myocardial infarction is 3,2 times higher than in unstable angina. Patients with unstable angina have the highest IGF-I levels: 1,2 times higher than in control group. Lowest IGF-I levels were in the fatal group (mortality due to infarction): 1,27 times lower than in control group. Conclusion. PAPP-A and IGF-I are new biochemical markers of intravascular damage and atherosclerotic plaque repair. They can be used in emergency cardiology to analyze damage and morphological instability of atherosclerotic plaques in acute coronary syndrome.