Биомаркеры воспаления и эндотелиальной дисфункции у пожилых пациентов с инфарктом миокарда, артериальной гипертензией и синдромом старческой астении

Aim. To analyze the level of biomarkers of inflammation and endothelial dysfunction in elderly patients with myocardial infarction (MI), hypertension (HTN) and frailty. Material and methods. Three following clinical groups were formed: patients aged 60-74 years with MI+ grade 1-2 HTN (n=80); patients aged 60-74 with MI+HTN+prefrailty (n=52); patients aged 60-74 years with MI+HTN+frailty (n=114). In patients of all groups 2-4 months after MI, the levels of high-sensitivity C-reactive protein (hsCRP), intercellular adhesion molecule 1 (ICAM-1), nitric oxide (NO) metabolites — nitrates and nitrites, endothelin-1, desquamated endotheliocytes, vascular endothelial growth factor (VEGF) were determined. Results. Patients with MI+HTN+frailty had a higher hsCRP — 6,4 mg/l compared with patients with MI+HTN+ prefrailty (4,2 mg/l; p<0,01) and patients with MI+HTN (3,2 mg/l; p<0,01). The level of ICAM-1 was 315,6, 242,7, and 213,5 ng/ml, respectively, in these groups (p<0,01). Patients with MI+HTN+prefrailty, MI+HTN+frailty and MI+HTN had following levels of nitrite (NO₂^-) and nitrate (NO₃^-) — 6,7, 5,4, and 7,2 µmol/l (p<0,01). A similar ratio is inherent in NO₃^-. On the contrary, the content of desquamated endotheliocytes and VEGF was significantly higher in patients with MI+HTN+frailty compared with patients with MI+HTN+ prefrailty (p<0,01). The level of endothelin-1 was also significantly higher in patients with MI+HTN+frailty compared with the MI+HTN+prefrailty group: 18,85 vs 13,41 fmol/l (p<0,05). Conclusion. The levels of inflammation and endothelial dysfunction in patients with MI+HTN are significantly higher than those in patients with MI+HTN+frailty compared with patients with MI+AH+prefrailty and MI+HTN, with the exception of nitric oxide metabolites.