ST-elevation myocardial infarction: Profile of certain serum biomarkers and colon microbiota
Abstract. Acute forms of coronary heart disease remain to be the leading cause of morbidity and mortality. Inflammation and condition of the intestinal microbiota may be underestimated factors of residual risk.Stepanov M.S., Karpunina N.S., Godovalov A.P.
The aim: to determine the level of certain proinflammatory serum markers and condition of the colon microbiota in patients with ST-elevation myocardial infarction (STEMI) in different age groups.
Material and methods. The study included 65 patients: group 1 – 11 males with STEMI aged 25–44 years, group 2 – 54 individuals with STEMI aged 45-60 years (87% male patients). The control group for cytokine levels (group 3) included 25 healthy individuals (64% males). In addition to routine tests, study participants had measurement of their levels of interleukins 6, 1β, 18, C-reactive protein, tumor necrosis factor-alpha, monocyte chemotactic protein-1, and fatty acid binding protein (FABP). Intestinal microbiota was analyzed using a bacteriological method.
Results. Reliable differences between patients with STEMI of different ages were obtained for the content of FABP in the blood: its values in the 1st, 2nd, and control groups were 0.07 [0.06; 0.1], 0.14 [0.08; 0.27] and 0.07 [0.07; 0.08] pg/ml, respectively (p1–2 = 0.004, p2–3 = 0.000). Two main study groups differed significantly in the level of proinflammatory cytokines from the control group. Patients in group 2 were characterized by a decrease in the number of lactobacilli relatively to the age-related norm (59.2 versus 66.7%, p = 0.002), an increase in opportunistic pathogens, Candida spp. and Staphylococcus spp. In this group, Escherichia coli with normal enzymatic activity was less common than in group 1 (64.8 versus 100%, p = 0.0007). Patients in group 1 more often had an increase in the number of Clostridium spp. (83.3 versus 14.8%, p = 0.000), atypical forms of E. coli (78.8 versus 42.6%, p = 0.00) and Klebsiella pneumoniae (16.7 versus 11.1%, p = 0.000).
Conclusion. Data indicating a unidirectional reaction of proinflammatory molecules in patients with STEMI of different ages are obtained. Quantitative changes in the main intestinal microorganisms without any significant differences in this index in patients of different age groups were found.
Keywords
myocardial infarction
troponin
GRACE scale
intestinal microbiocenosis
interleukins
fatty acid binding protein
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About the Authors
Maxim S. Stepanov, MD, postgraduate student of the Department of hospital therapy and cardiology, Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia. Address: 614990, Perm, 26 Petropavlovskaya St.E-mail: maximpractice@gmail.com
Natalia S. Karpunina, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of hospital therapy and cardiology, Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia. Address: 614990, Perm, 26 Petropavlovskaya St.
E-mail: karpuninapsma@mail.ru
ORCID: https://orcid.org/0000-0003-3127-1797
Anatoly P. Godovalov, MD, PhD (Medicine), associate professor, associate professor of the Department of microbiology and virology, Academician E.A. Wagner Perm State Medical University of the Ministry of Healthcare of Russia. Address: 614990, Perm, 26 Petropavlovskaya St.
E-mail: agodovalov@gmail.com
ORCID: https://orcid.org/0000-0002-5112-2003
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