L.S. Mkhitaryan, O.B. Kuchmenko, V.O. Shumakov, I.E. Malynovska, I.N. Ievstratova, N.M. Tereshchenko, N.M. Vasylynchuk, T.F. Drobotko. Qualitative status of lipid factors of atherogenesis and intensity of inflammatory reaction in patients after acute myocardial infarction

The aim – to evaluate the qualitative status of the main classes of lipoproteins together with activity of corresponding enzymes, leukocyte elastase and matrix metalloproteinase-12 in patients with coronary heart disease that have experienced acute myocardial infarction with urgent revascularization of infarct-dependent coronary artery.
Material and methods. The study involved 32 patients (mean age of 53.1±1.6 years), who received basic therapy according to the current guidelines, including lipid-lowering drugs (statins). Blood biochemistry assays were performed 4-6 weeks after myocardial infarction.
Results. The patients demonstrated high level of free radical oxidation of proteins, associated with oxidation of LDL, VLDL, and HDL with higher index of their oxidative modification and blood atherogenic potential. Increase of myeloperoxidase, leukocyte elastase and matrix metalloproteinase-12 activity and decrease of paraoxonase-1, catalase and superoxide dismutase activity were observed in patients in comparison to healthy controls.
Conclusion. Changes of myeloperoxidase and paraoxonase-1 activity may serve as predictor of inflammation involving neutrophils, and atherosclerosis, as well as to assess the treatment efficiency. Increase of myeloperoxidase, leukocyte elastase and matrix metalloproteinase-12 may play an important role in destabilization of atherosclerotic plaques and be a biochemical marker to predict possible occurrences of this complication. The most informative indicators of the state of blood lipoproteins and their atherogenicity is the activity of lipoprotein-associated enzymes (paraoxonase-1 and myeloperoxidase), and not just the level of lipoprotein cholesterol.

Full article