Despite the accumulated data, the role of biomarkers of endothelial dysfunction in assessing the risk and predicting the severity of coronary artery involvement in coronary artery disease (CAD) has not yet been studied.

OBJECTIVE

To evaluate the quantitative profile of biomarkers of endothelial dysfunction (endothelin-1, vascular endothelial growth factor A (VEGF-A), homocysteine) in middle-aged men with chronic coronary syndrome and acute coronary syndrome without ST segment elevation, and to determine the relationship between the levels of these markers and the severity of atherosclerotic lesions of the coronary arteries based on coronary angiography data.

MATERIALS AND METHODS

The study included 192 men (mean age 55.1±3.4 years) divided into three groups. Serum endothelin-1, VEGF-A, and homocysteine levels were measured in all participants. Instrumental studies were performed in patients with coronary artery disease, including electrocardiography, echocardiography, and selective coronary angiography.

RESULTS

The highest levels of endothelin-1 (4.83±1.02 pg/mL; F=14.09; p=0.0001) and VEGF-A (62.88±17.16 pg/ml; F=7.55; p=0.00060) were observed in the group of patients with acute coronary syndrome without ST segment elevation. In middle-aged men with CAD, an endothelin-1 level of ≥3.2 pg/mL was associated with the risk of developing acute coronary syndrome without ST segment elevation and a level of ≥4.3 pg/mL was associated with the risk of repeated percutaneous coronary intervention. An increase in VEGF-A above 67.9 pg/mL was associated with restenosis of the coronary arteries, and an increase in serum levels of endothelin-1 and homocysteine was associated with the progression of coronary atherosclerosis. In middle-aged men with CAD, increased serum VEGF-A levels were associated with stent restenosis.

CONCLUSION

The obtained results warrant studying biomarkers of endothelial dysfunction as tools for predicting the clinical outcomes of chronic coronary syndrome into acute coronary syndrome.