Mezhiievska I. Clinical and prognostic value of the level of growth stimulating factor expressed by gene 2 in the course of acute myocardial infarction without ST segment elevation

The main clinical group of the study was presented to 90 patients with NSTEMI aged 38 to 79 (mean 61.3 ± 1.1) years. The study first analyzed the variability of ST2 levels in NSTEMI, determined on the 1st day of myocardial infarction (MI) before coronary ventriculography (CVG). On the basis of instrumental researches the high informativeness of the GRACE score for stratification of the course NSTEMI is substantiated. For the first time, it was found that relatively high (RH) plasma ST2 levels (> 56 ng / ml) are associated with more severe anatomical lesions of the CA and impaired structural and functional condition of the left ventricle (LV). Using Spearman's rank correlation analysis and multiple linear regression, a clinical-instrumental profile of patients with NSTEMI and various plasma ST2 level was determined for the first time. The study revealed for the first time that the clinical course of NSTEMI is due primarily to the nature of neurohumoral regulation of the cardiovascular system and anatomical lesions of the CA. For the first time it was proved that the development of acute cardiac arrhythmias in patients with NSTEMI is associated primarily with increased plasma ST2 levels, signs of heterogeneity of LV myocardial repolarization, age of patients and smoking, the presence of structural remodeling of the left atrium. In turn, the paper showed for the first time that the development of acute heart failure in NSTEMI is associated primarily with increased plasma ST2 levels and anatomical lesions of the CA, impaired LV contractility and the presence of diabetes mellitus. The clinical and instrumental predictors of the development of complicated course and specific cardiac complications in NSTEMI identified in the study open the prospect for the selection of certain pathophysiological targets, the impact of which will improve the course of NSTEMI and increase patient survival.