Prognostic biomarkers of risk and progression of coronary heart disease in patients with chronic obstructive pulmonary disease
Annotation. Currently, the problem of associated pathology of bronchopulmonary and cardiovascular systems will be considered not only as a combination of different diseases, but also as severe condition with common pathogenetic links. This fact is increasingly recognized in the context of “the cardio-pulmonary continuum”. The aim of the study is to determine the significance of biomarkers characterizing the role of lipid disorders and the processes of destruction of atherosclerotic plaques for early diagnosis of CHD in patients with COPD. 197 men were examined, including 153 people with COPD and 44 patients with stable СHD II, III FC (mean age of 56,4±3,8 years). The level of LP (a) and PAPP-A were determined using ELISA. Statistical processing of results was performed using software “Statistica” V. 10.0 and “Microsoft Office Excel 2010”. There were the differences in the lipid spectrum of blood in patients with isolated pulmonary disease and COPD in combination with CHD. The average level of LP (a) in the group of patients with isolated COPD was 18,53±3,73 mg/dL (p>0,05), CHD patients — 46,27±2,78 mg/dL (p<0,05), in patients with comorbidity pathology 49,43±3,11 mg/dL (p<0,05). This allowed us to identify the level of LP (a) more than 17 mg/dL as a possible predictor of CHD. Method binary logistic regression established a highly significant impact of having CHD on the level of PAPP-A in patients with combined pathology: OR=14,516; CI=6,627-31,798; while the impact of COPD on the rate of increase in the level of PAPP-A was not significant. Confirmed the importance of introducing a definition of biomarkers of risk and progression of СHD in patients with COPD, namely the level of LP (a) and of PAPP-A. There is a need to conduct epidemiological studies to better understand the mechanisms, diagnostic and prognostic value of PAPP-A and LP (a) in asymptomatic subjects and in subjects with well-documented coronary heart disease in the presence of cardiorespiratory pathology.
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