cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2020.11.n1251cardio-1251Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESФактор дифференцировки роста-15 у пациентов в острой стадии инфаркта миокардаLevel of the growth differentiation factor-15 in patients with acute myocardial infarctionhttps://orcid.org/0000-0002-2130-0593СабирзяноваА. А.SabirzyanovaA. A.

аспирант кафедры кардиологии ФПК и ППС КГМУ

Ph.D. student, Department of Cardiology, Kazan State Medical University

S2101-Sash@yandex.ruhttps://orcid.org/0000-0002-4510-6197ГалявичА. С.GalyavichA. S.

д.м.н., профессор, зав.кафедры кардиологии ФПК и ППС КГМУ

Professor, Head of the Department of Cardiology, Kazan State Medical University

agalyavich@mail.ruhttps://orcid.org/0000-0002-7974-5894БалееваЛ. В.BaleevaL. V.

к.м.н., ассистент кафедры кардиологии ФПК и ППС КГМУ

Assistant of the Department of Cardiology, Kazan State Medical University

larisabaleeva151@gmail.comhttps://orcid.org/0000-0002-9580-3695ГалееваЗ. М.GaleevaZ. M.

к.м.н., доцент кафедры кардиологии ФПК и ППС КГМУ

Associate Professor, Department of Cardiology, Kazan State Medical University

maktub29@mail.ruФГБОУ ВО «Казанский государственный медицинский университет» Минздрава РФ, КазаньРоссияKazan State Medical University, Kazan, RussiaRussian Federation202015122020601142–48Copyright © Kardiomag, 20202020KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1251

Цель Выявить взаимосвязи фактора дифференцировки роста-15 (GDF-15) с лабораторными и клинико-инструментальными показателями у пациентов с инфарктом миокарда в острой стадии.Материал и методы В исследование включено 118 пациентов в возрасте до 70 лет с инфарктом миокарда (ИМ) с подъе­мом сегмента ST или без подъема сегмента ST, у которых проведено определение GDF-15 методом иммуноферментного анализа в первые 48 часов от начала клинической картины ИМ, наряду с рутинным обследованием. Статистическая значимость различий количественных показателей оценивалась по t-критерию Стьюдента для нормального распределения и по непараметрическому U критерию Манна–Уитни, качественных показателей – по критерию χ2 Пирсона. В качестве показателя наличия связи между количественными показателями использовался коэффициент корреляции Пирсона и коэффициент ранговой корреляции Спирмена.Результаты Средний уровень GDF-15 у пациентов с ИМ составил 2,25±1,0 нг/мл. Выявлены умеренные корреляционные связи GDF-15 с уровнями натрийуретического пептида (r=0,36, p<0,01), лейкоцитов (r=0,32, p<0,01), фракцией выброса по Симпсону (r=-0,32, p<0,01), слабые – с уровнями тропонина I (r=0,21, p=0,02), мочевины (r=0,20, p=0,04) и с толщиной межжелудочковой перегородки по данным эхокардиографии (r= -0,26, p<0,01). GDF-15 оказался выше у пациентов с ИМ с подъемом сегмента ST (2,36±1,02 против 1,99±0,96, p<0,05) и при наличии зон гипо- или акинеза (2,35±1,05 против 1,85±0,70, p<0,05). Не было выявлено зависимости GDF-15 от наличия у пациентов традиционных сердечно-сосудистых факторов риска.Заключение GDF-15 коррелирует с основными маркерами повреждения миокарда, его уровень выше у пациентов с ИМ с подъемом сегмента ST вне зависимости от локализации инфаркта.

Aim To reveal relationships between growth differentiation factor-15 (GDF-15) and laboratory and instrumental indexes in patients with myocardial infarction in acute phase.Material and methods The study included 118 patients younger than 70 years with ST-segment elevation or non-ST segment elevation myocardial infarction (MI). For these patients, GDF-15 was measured by enzyme immunoassay within 48 h of MI clinical onset along with a routine examination. Statistical significance of differences in qualitative variables was assessed by the Student’s t-test for normal distribution and by the nonparametric Mann-Whitney U-test; significance of differences in quantitative variables was assessed by the Pearson’s chi-squared test. The presence of a relationship between quantitative variables was assessed with the Pearson’s correlation coefficient and the Spearman’s rank correlation coefficient.Results For patients with MI, mean GDF-15 concentration was 2.25±1.0 ng/ml. Moderate correlations were found for GDF-15 and levels of natriuretic peptide (r=0.36, p<0.01), white blood cells (r=0.32, p<0.01), and ejection fraction (Simpson rule) (r=-0.32, p<0.01); weak correlations were found with levels of troponin I (r=0.21, p=0.02) and urea (r=0.20, p=0.04), and interventricular septal thickness by echocardiography (r= -0.26, p<0.01). GDF-15 was higher in patients with ST-segment elevation MI (2.36±1.02 vs 1.99±0.96, p<0.05) and in the presence of hypo- or akinetic areas (2.35±1.05 vs 1.85±0.70, p<0.05). No dependence of GDF-15 on the presence of traditional cardiovascular risk factors was observed.Conclusion GDF-15 correlates with major markers of myocardial injury; its level is higher in patients with ST-segment elevation MI regardless of the infarct location.

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The authors declare that there are no conflicts of interest present.