Nazarova M. Clinical and pathogenetic significance of antiphospholipid syndrome components in men with stable ischemic heart disease and postinfarction cardiosclerosis

164 men with stable CHD and postinfarction cardiosclerosis were examined. Among the examined patients there were 75 % of people who underwent a Q - myocardial infarction (Q-MI). 93 (56.7 %) patients showed positive levels of total aPL and anti-beta2-GP1 IgG, low-positive levels of one or both types of antibodies were detected in 58 (35.4 %) patients, medium-positive levels of one or both types were detected in 35 (21.3 %) patients. The proportion of patients with negative levels of aPL and anti-beta2-GP1 IgM was 43.3 % versus 70.8 % in the control group. Positive levels of aPL and anti-beta2-GP1 IgM were found in 11.6 % of patients with CHD and in 6.2 % of people in the control group. Positive levels of aPL and anti-beta2-GP1 IgG are closely associated with manifestation of MI up to 44 years. Patients with CHD with positive levels of aPL and anti-beta2-GP1 IgG more often had low levels of HDL cholesterol (in 2.77 times, p<0.05) than patients with negative levels of antibodies. Differences in other cardiovascular risk factors were insignificant. In 6.7 % of patients with CHD, low-positive levels of anti-PR3/MPO IgG were detected on the background of positive levels of aPL or anti-beta2-GP1 IgG. In patients with CHD, there was an increase of levels of TLR2 and TLR4 relative to the control group. Elevations of TLR2 and TLR4 were significantly associated with positive levels of aPL and anti-beta2-GP1 IgG. It was found that chances of increasing levels of TLR2 and TLR4 in the postinfarction period increased significantly in patients with CHD after Q-MI. Patients with CHD with positive levels of aPL and anti-beta2-GP1 IgG showed a more obveous deterioration of echocardiographic indicators of systolic and diastolic LV function, a higher frequency of LVH, lower frequency of the preserved LV ejection fraction (LV EF > or = 50 %) than in patients with negative levels of antibodies.