Common and distinct changes of multi-marker panel in acute and chronic non-obstructive coronary syndromes

Objectives Applying the multi-marker panel in patients with STEMI, NSTEMI and non-obstructive chronic coronary disease (no-CCD) aiming for the estimation of either common or non-common changes of admission levels of 37 markers. Methods The descriptive analytical study was conducted on 3 equal groups of patients (n=80 each) with STEMI, NSTEMI and no-CCD formed on the basis of a longitudinal cohort study comprising 516 patients with STEMI, 627 with NSTEMI and 173 patients with no-CCD. Serum levels of markers were determined by ELISA and cell flow cytometry. Results IL-1ß, soluble receptor of IL-6, TNF-α and hsCRP increased in all 3 groups, excepting normal level of neopterin and IL-10 inherent to no-CCD. Commonly for endothelial dysfunction was elevation of endocan and angiopoietin 2 (Apo2), whilst raising of endothelial microparticles characterized acute coronary syndrome (ACS). Decreased paraoxonase 1, Ang1-7/Ang II ratio and catestatin, as well as increased oxi-HDL, LP(a), Willebrand/ADAMTS13 ratio, neprilysin and growth differentiation factor 15 (GDF-15), are common signs as well. Conclusions Quite many similar changes of markers in patients with ACS and no-CCD suggest a pathogenic interface consisting of common pillars, which conceptually might also predict the coronary microcirculatory dysfunction often occurred in these pathologies.