Risk assessment of acute coronary syndrome based on the study of cytokine profile and serum proteolytic activity
Vitebsk State Medical University, Vitebsk, Belarus
The article describes the features of cytokine profile and proteolytic activity of blood serum among patients with various forms of coronary artery disease. It was determined that the concentration of cytokines IL-6, IL-8, TNF-α, adhesion molecule sVCAM-1 and trypsin-like activity of blood serum were reliably higher in the group of patients with myocardial infarction than in the group of patients with stable angina pectoris and the control group. Rise of IL-6 and IL-10 concentration after 12-14 days of hospital stay was also demonstrated among patients with myocardial infarction. A model for assessing the risk of acute coronary syndrome is proposed that includes 3 or more of the following features at once: concentration of interleukin-6 >3,045 PG/ml, interleukin-8 >26,615 PG/ml, TNF-alpha >29,701 PG/ml, sVCAM-1 >44,36 PG/ml, and BAPNA-amidase activity >2,173 pkat. The odds of developing acute coronary syndrome in such patients are 19 times higher (Ìå;LQ-UQ: 3,626-76,952) if compared to patients with stable form of coronary artery disease who has no above listed signs. The specificity of the proposed model is 77.19%, sensitivity – 89.74%, the percentage of correct prediction is 83.46% (AUC=0.927; p<0.001). The statistical characteristics of the proposed model of risk assessment are better than those of the known models of acute coronary event’s risk including cytokines in their composition (as model of A.V. Schmidt and KEM Score).