Borovyk K. The role of vitronectin and galectin-3 in the development and prediction of the course of acute myocardial infarction in combination with obesity.

The work is dedicated to increasing the effectiveness of diagnosis and treatment of patients with acute myocardial infarction with concomitant obesity based on the evaluation of activity of vitronectin and galectin-3, as well as the study of their predictive value in the development of unfavorable course of acute myocardial infarction. The conducted study shows that in patients with acute myocardial infarction an increase of galectin-3 level by 32.4% and vitronectin concentration by 25.9% is observed along with an increase in low-density proatherogenic lipoproteins, decrease in the physical component of the quality of life in the presence of obesity, multi-vascular lesions of the coronary arteries and complicated course of the hospital period of a cardiovascular event. The presence of hypergalectinemia and vitronectinemia in patients with acute myocardial infarction and obesity is accompanied by an increase in the severity of atherosclerotic lesions of the coronary vessels. In patients with acute myocardial infarction and obesity an increase in the volume of the left ventricle and a decrease in its contractility are determined with an increase in the parameters of myocardial-arterial stiffness. The growth of body mass index and the progression of abdominal obesity in patients with acute myocardial infarction is accompanied by hypervitronectinemia and hypergalectinemia, which are interrelated with an increase in the end-systolic (r=0.44; p<0.05 and r=0.64; p<0.05 respectively) and the end-diastolic (r=0,48; p<0.05 and r=0.57; p<0.05 respectively) volumes and a decrease in contractility (r=-0.41; p<0.05 and r=-0.38; p<0.05 respectively) together with an increase in low density lipoprotein level with high activity of galectin-3. The use of acetylsalicylic acid in combination with both ticagrelor or clopidogrel as part of dual antiplatelet therapy after acute myocardial infarction in patients with obesity contributed to a considerable decrease in vitronectin and galectin-3 levels, as well as it is accompanied with more significant reduction of the risk of cardiovascular events in conditions of primary percutaneous intervention as a method of reperfusion and by use of acetylsalicylic acid with ticagrelor in treatment of the high-risk group in the postponed post-infarction period. Levels of galectin >12.83 ng/ml and vitronectin >283.26 ng/ml can be considered as predictors of recurrent cardiovascular events within 6 months after myocardial infarction in patients with obesity.