Динаміка показників імунологічного статусу та ліпідного обміну у хворих на хронічну ішемічну хворобу серця в зіставленні з розвитком серцево-судинних подій протягом тривалого спостереження
Authors: Lomakovsky O. M. , Lutay M. І. , Gavrilenko T. I. , Pidgaina O. A. 
Published: September 2022

The aim – to assess the relationship between the dynamics of immunological and blood lipoproteid indicators in patients with chronic coronary artery disease and the development of cardiovascular episodes compared to patients with coronary artery disease without such episodes during 6.5 years of observation.Materials and methods. Patients with coronary artery disease with stable angina pectoris were divided into two groups: the first group (n=46) included patients without cardiovascular events during the observation period, the second group (n=36) included patients with the occurrence of such events within 6.5 years of observation. The material of the immunological study was peripheral venous blood. To determine the parameters of cellular and humoral innate and adaptive immunity in blood serum and supernatants of mononuclear cells, enzyme immunoassay was used.Results and discussion. Comparison of the dynamics of T-cell immunity: in the second and first groups, the dynamics of medians of T-suppressors (CD8) – from 22 to 33 (p=0.018) versus 27 to 33 % (p=0.10), the number of lymphocytes with a tendency to apoptosis in the second and first groups it was equal – from 18 to 27 (p=0.11) versus from 12 to 29 % (p=0.002). Between patients with the development of cardiovascular events compared with patients without them, the dynamics of median CRP, respectively, was from 6.7 to 7.8 (p=0.043) versus 3.2 to 3.8 mg/l (p=0.024), IL-6 in mononuclear cells – from 2239 to 5788 (p=0.47) vs. 2127 to 5544 pg/ml (p=0.005), IL-8 in mononuclear cells – from 2305 to 3536 (p=0.028) vs. from 1980 to 3820 pg/ml (p=0.0004), anti-inflammatory IL-10 in mononuclear cells – from 95 to 44 (p=0.69) vs. 220 to 68 pg/ml (p=0.97). Between patients of the second group, compared with the first, the dynamics of median levels of total cholesterol compared, respectively, from 6.9 to 6.0 (p=0.07) versus 5.9 to 6.5 mmol / l (p=0.15), triglycerides (TG) – from 2.2 to 1.1 (p=0.08) vs. 1.9 to 1.5 mmol/l (p=0.030), HDL cholesterol – from 1.15 to 1.28 (p=0.89) versus 1.10 to 1.40 mmol/l (p=0.0005), the dynamics of the median degree of peroxide modification of lipoproteins was from 7.1 to 2.6 (p=0.14) versus from 5.4 up to 3.1 conventional units (p=0.0008), free radical oxidation of proteins – from 3.3 to 5.0 (p=0.028) compared with 4.6 to 5.1 conventional units. (p=0.54).Conclusions. In patients with stable coronary artery disease, the activity of immune inflammation significantly increases for 6.5 years. The development of cardiovascular events is not accompanied by the peculiarities of the growth of immune inflammation indicators, the peculiarities of changes in the studied parameters of the humoral link of acquired immunity and the parameters of the phagocyte system in comparison with patients without such events. The occurrence of cardiovascular events is accompanied by greater activation of T-lymphocytes and a lower increase in the number of lymphocytes with a predisposition to apoptosis, a significant increase in free radical oxidation of proteins during this period compared to patients without such complications. The absence of the development of cardiovascular events is combined with a significant increase in HDL cholesterol during statin therapy.