Screening Assessment of the Immune Status of Patients With Acute Coronary Syndrome

The aim of the work was to determine the differences in the clinical picture and immunological status in patients with ACS and PCS taking into account the level of TREC in the peripheral blood. Materials and methods. A total of 32 patients aged 40 to 65 years with acute coronary syndrome (ACS) and a history of COVID-19 from 6 to 18 months were examined. All patients underwent coronary angiography and stenting of the coronary arteries. To determine TREC levels in peripheral blood, the TREC/KREC-AMP PS reagent kit (Pasteur Research Institute, St. Petersburg) was used. To determine the studied subpopulations of peripheral blood lymphocytes, Beckman Coulter (USA) reagents - TetraChrome were used. The analysis of samples was studied on a Navios™ flow cytometer (Beckman Coulter, USA). Results and discussion. Of the patients with ACS and SCS, the TREC content was determined in 32 patients, including 28 with unstable angina and 3 with acute myocardial infarction without ST segment elevation. The patients were divided into groups depending on the TREC content: with a reduced TREC level (one group) and normal (the second group). As for KREC, it should be noted that only one patient from the subjects had a reduced indicator, while the rest had it within the normal range, therefore, in our work, we did not find the effect of KREC on clinical and immunological features of individuals with ACS and SCS. Individuals with reduced TREC had a lower relative and absolute number of T-helpers (p0.01), and the immunoregulatory index was lower (p0.01). At the same time, an increase in the relative (p0.01) and absolute number of T-cytotoxic cells (p0.05), as well as the percentage of T-NK lymphocytes (p0.05) was noted in this group of patients. Also, in patients of the first group, there was a tendency to an increase in NK lymphocytes and a decrease in B lymphocytes (CD3- CD19+). Conclusions: Patients with acute coronary syndrome and PCOS with reduced TREC had a more severe clinical picture, but given that the sample is not very significant yet, further study of such patients is planned and with a larger set of patients, the reliability of those changes to which the trend has been identified so far may be added. Detection of disorders using the proposed screening methods requires the formation of approaches to immunocorrection of such disorders, which are currently only being discussed in cardiology.