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Aim. To assess clinical and predictive value of serum IL-18 in ST elevation myocardial infarction.Material and methods. Totally, 132 patients included, hospitalized to Kemerovo cardiovascular dispensary due to STEMI with

Aim. To evaluate clinical significance of serum NGAL in ST elevation myocardial infarction (STEMI) patients in relation with the occurrence of in-hospital period complications.Material and methods. Totally 260 men included with STEMI, hospitalized in 24 hours after the onset of clinical symptoms of the disease. The measurement of serum NGAL concentration (ng/ml, sNGAL) at 1st and 2nd day of hospitalization was done with the hard-phase immune-enzyme analysis by Hycult® biotech assay (USA), registration was done on the plain reader “UNIPLAN” (SPF “PIKON”, Russia). At the stage of in-hospital treatment we registrated endpoints — signs of coronary failure (early post infarction angina, recurrent MI), grade of acute coronary failure (Killip I-IV class), grade of chronic heart failure (by NYHA), hospital mortality.Results. Patients were selected into 2 groups depending on the endpoints occurrence at hospital stage. Adverse hospital outcome (at least one endpoint) was found in 83 (32%) patients. The level of renal damage sNGAL, measured on the 1st day did not reveal any difference between groups with adverse or benign course of MI in hospital, and on 12th day the sNGAL concentration was significantly higher in group with adverse course — 2,1 ng/ml (1,44; 2,8) vs 1,55 ng/ml (1,11; 2,3), p=0,033. Monofactor analysis showed significance for adverse outcome, the factors as 2nd type diabetes, age >60 y., the fact of glomerular filtration rate decline during hospitalization, increase of sNGAL by 12th day. By the result of multifactor analysis — increase of the age by 1 year increases the chance of adverse outcome by 14%, increase of sNGAL by 12th day of MI increases adverse outcome chance by 3,2 times. the level of sNGAL ≥1,046 ng/ml associated with complicated course of in-hospital MI period.Conclusion. The level of sNGAL, measured on 1st day of MI did not have prognostic value for the inhospital complications, however concentration of sNGAL on 12th day was associated with already occured adverse outcomes, being a marker of MI severity.

Objective: To study the prognostic significance of serum NGAL (sNGAL) and cystatin C in the acute phase of ST-segment elevation myocardial infarction (STEMI) in the late disease period. Material and Methods: 357 patients with STEMI, admitted to hospital within 24 h of symptom onset, were included in the study. Serum creatinine levels with the calculation of glomerular filtration rate (GFR) using the MDRD as well as levels of sNGAL and cystatin C were measured on day 1 and 12–14. Results: All patients were divided into 2 groups according to their estimated GFR: with and without renal dysfunction (RD), defined as a decrease of GFR < 60 ml/min/1.73 m2. Within 3 years of follow-up, the composite endpoint (CEP) were assessed (CEP – death + non-fatal cardiovascular events). The ROC curve analysis was used to determine the thresholds for every biomarker, involved in the CEP development: NGAL (≥ 1.25 ng / ml) and cystatin C (≥ 1.9 mg / l). On day 12–14 of hospitalization elevated NGAL ≥ 1.25 ng / mL was associated with a 3-fold increased risk for adverse cardio vascular events in a 3-year follow up after STEMI; whereas, elevated cystatin C ≥ 1.9 mg/l – with a 2-fold increased risk for the CEP, and signs of RD, found in patients before the discharge from the hospital, – with a 1.5-fold increased cardiovascular risk. The model considering an increase of NGAL over 1.25 ng / l has the highest prognostic value, while the models based on the levels of cystatin C and GFR are of equal prognostic value. Conclusion: The most promising issue in the prognosis of long-term adverse outcomes in patients with STEMI may be considered the assessment of RD using new biomarkers such as sNGAL.

The course of perioperative period in 719 patients undergoing CABG in the Research Institute for Complex Issues of Cardiovascular Diseases between March, 2011 and April, 2012 was evaluated. All the patients had creatinine concentrations, glomerular filtration rate (GFR by MDRD) and daily urine microalbumin levels measured before CABG and at day 7 after CABG. Major event rates were assessed (myocardial infarction, stroke or transient ischemic attack, acute or decompensated chronic renal failure or remediastinotomy) during the hospital stay. The EuroSCORE was calculated for each patient. Different EuroSCORE risk patients had similar serum creatinine levels while microalbumin concentrations in daily urine were significantly higher in moderate and high EuroSCORE risk groups before the surgery as compared to low-risk patients. Patients who experienced postoperative events had significantly higher microalbuminuria both before and after surgery while there were no differences in such renal dysfunction markers as creatinine and GFR. Preoperative microalbuminuria assessment can act as a marker of complicated postoperative period after CABG.