Circulating markers of vascular damage as predictors of cardiovascular events in atherosclerosis and metabolic disorders
The article presents the results of cluster analysis of the contribution of immune inflammation and endothelial dysfunction (ED) markers to the frequency and severity of cardiovascular events (CVE) in cohorts of patients with asymptomatic atherosclerosis (AAS), coronary artery disease (CAD), type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) during a 3-year prospective observation.
Results Circulating markers of ED and immune inflammation, such as ET-1, IL-1β, TNF-α, antibodies to collagen type I and III, and antibodies to chondroitine sulfate (CS) contribute to cardiovascular (CV) manifestation in AAS. In CAD patients ET-1, eNOs, antibodies to collagen, as well as IL-6 and vWf are the main contributors. In T2DM without clinical manifestation of CAD, the set of markers associated with the adverse events includes ET-1, eNOs, IL-6, anti-C, and anti-HA. In CAD combined with T2DM, the cluster of markers associated with the adverse events includes vWf, TNF-α, eNOs, IL-6, anti-C, anti-HA and CRP. In AAS without MS, the key contributors are ET-1 and vWf, and the presence of anti-C and anti-ChS; in AAS/MS patients, the key markers are IL-1β, TNF-α, anti-C, anti-ChS, anti-HA, and CRP. In CAD without MS, the cluster of markers associated with adverse events includes ET-1, eNOs and anti-HA; in CAD/MS it includes anti-C, ET-1, and IL-6.
Conclusion. The obtained results confirm the role of systemic inflammation in the development of atherosclerosis-associated angiopathy in coronary pathology and disorders of carbohydrate metabolism, and also suggest a set of circulating markers as predictors of adverse CVE.
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