Immuno-inflammatory markers in patients with ischemic heart disease

Background. Ischemic heart disease remains one of the leading causes of morbidity, disability, and mortality worldwide. Current evidence indicates that chronic immune inflammation, endothelial dysfunction, and impaired angiogenic regulation play an important role in the development and progression of atherosclerotic coronary artery disease. Assessment of relationships between immunoinflammatory biomarkers, growth factors, and structural and functional cardiovascular changes may improve understanding of disease progression and provide additional criteria for evaluating its severity.

Aim. To evaluate immunoinflammatory markers and growth factors in patients with ischemic heart disease and determine their associations with clinical and instrumental cardiovascular parameters.

Materials and methods. The study included 234 middle-aged patients (mean age 52.4 ± 1.27 years) with arterial hypertension and ischemic heart disease and 60 apparently healthy controls. Ischemic heart disease and arterial hypertension were verified according to World Health Organization criteria and the International Classification of Diseases, 10th Revision. Arterial hypertension was classified according to the 2017 ACC/AHA Hypertension Guidelines, while stable effort angina was classified according to the functional classes of the Canadian Cardiovascular Society. All participants underwent clinical and instrumental assessment, including echocardiography, coronary angiography, and duplex ultrasonography of the carotid arteries. Serum concentrations of immunoinflammatory markers and growth factors were measured. Statistical analysis included descriptive statistics and correlation analysis.

Results. Patients with ischemic heart disease demonstrated a significant increase in immunoinflammatory marker levels with increasing clinical severity. The most pronounced changes were observed in IL-17A, IL-6, IL-1β, TNF-α, and complement component C3, as well as in VEGF-A, IGF-1, and TGF-β1. Statistically significant correlations were identified between these biomarkers and coronary artery diameter, carotid intima-media thickness, and echocardiographic parameters. These findings indicate an association between increased immunoinflammatory activity, vascular remodeling, and structural and functional myocardial changes.

Conclusion. The results confirm the important role of immune inflammation, endothelial dysfunction, and growth factor dysregulation in the pathogenesis of ischemic heart disease. Combined assessment of the investigated biomarkers may be promising for additional evaluation of disease severity and cardiovascular remodeling.

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