Hyperlipidemia, inflammatory markers, and structural-mechanical properties of blood cells in patients with stenosing atherosclerosis of coronary arteries

Despite the successes of preventive medicine associated with the effective impact on modifiable risk factors for diseases of the circulatory system (DCS), the leading cause of mortality worldwide remains ischemic heart disease. Results from clinical studies indicate the varying prognostic value of inflammatory markers in the development and progression of the atherosclerotic process.

Study Objective. To assess the nature of lipidemia, systemic inflammation indices (SIRI, AISI, SII, NLR, PLR, MLR), and the morphological and local mechanical properties of blood cells using atomic force microscopy in patients with stenotic atherosclerosis of the coronary arteries.

Materials and Methods. The study included 58 patients with instrumentally confirmed hemodynamically significant stenosis of the coronary arteries, where revascularization was either technically impossible or rejected by the patients. Of these, 72.4% (n = 42) were men and 27.6% (n = 16) were women. The mean age was (59.1 ± 4.4) years. All patients had their blood lipid profile determined, a complete blood count with leukocyte formula and calculation of inflammatory indices performed, and diagnostics of microhemodynamic disorders conducted. In 10 subjects, the structure and local mechanical properties of fixed formed blood elements (erythrocytes and platelets) were examined using an atomic force microscope.

Results. Among patients with stenotic multi-vessel coronary artery disease, the proportion of individuals with values exceeding the reference range for the neutrophil-to-lymphocyte ratio (NLR) was 22.4%, for the systemic inflammation response index (SIRI) – 58.6%, and for the systemic inflammation index (SII) – 29.3%. A direct, moderate-strength correlation was established between SIRI and the levels of prognostically unfavorable LDL-C (r = 0.49; p < 0.05), signs of atherosclerotic (r = 0.58; p < 0.05) multi-vessel (r = 0.43; p < 0.05) coronary artery lesions. A moderate-strength inverse correlation was found between anti-atherogenic HDL-C and the extent of atherosclerotic involvement of the coronary basin (r = –0.41; p < 0.05).

Conclusion. The identified correlations between the antiand atherogenic characteristics of the lipid profile, the severity of coronary atherosclerosis, and SIRI indicate the contribution of secondary hyperlipidemia and inflammation to the pathogenesis of atherosclerotic remodeling. According to atomic force microscopy of biomaterial from patients with stenosing atherosclerosis of the coronary arteries, it was found that a change in the elasticity of blood cell membranes (erythrocytes and platelets) is associated with an increase in the SIRI, SII, and AISI indices. This preliminary conclusion is based on a limited sample; the results of subsequent studies will be analyzed and presented upon completion of patient enrollment.

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