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LIPOPROTEIN A( a) LEVEL AND HUMORAL AND CELLULAR IMMUNITY
INDICATORS IN CORONARY ATHEROSCLEROSIS PROGRESSION IN
PATIENTS WITH STABLE CHRONARY DISEASE AFTER STENTING
Majidova G.T.
Kholikulova M.M.
Samarkand State Medical University, Samarkand, Uzbekistan
Republican Scientific Center of Emergency Medical Care, Samarkand, Uzbekistan
https://doi.org/10.5281/zenodo.15188728
Introduction.
Atherogenesis is based on a chronic inflammatory process developing in
the wall of large and medium arteries against the background of lipid metabolism disorders and
endothelial damage. Increased concentration of lipoprotein a( a) [ Lp (a)] in blood plasma is an
independent risk factor for the occurrence and development of atherosclerotic lesions of
various localizations.
Objective
. To analyze the relationship of Lp ( a ) and autoantibodies to Lp (a) and low-
density lipoproteins (LDL) with cellular inflammation indices and progression of coronary
atherosclerosis in patients with stable coronary artery disease
Methods
. The retrospective study included 46 patients with stable coronary artery
disease: group 1 - without progression (n=30) and group 2 - with progression (n=16) of
atherosclerosis during 22.4±8.7 months of observation according to coronary angiography
data. All patients took statins . Lymphocyte subpopulations ( Th1 , Th2, Treg , Th17) were typed
using direct immunofluorescence and flow cytometry. Biochemical studies included
determination of lipid spectrum parameters, Lp ( a), autoantibodies ( autoAb ) to Lp (a) and
LDL, as well as their oxidized derivatives.
Results
. The level of Lp ( a ) and the titer of class G autoAbs specific to Lp (a) and LDL
were higher in group 2 relative to group 1: Lp ( a ) - median 16.8 (9.5-35.5) mg/ dL and 6.5 (4.4-
15.9) mg/ dL , p=0.07, autoAbs to Lp (a) - 0.23±0.12 p.u. and 0.17±0.09 p.u. , p=0.08 and autoAbs
to LDL 0.22±0.07 p.u. and 0.17±0.06 p.u. , p=0.02, respectively. According to the correlation
analysis, the absolute content of Th17 (CD4+IL17+) in the blood correlated with the titer of
autoAbs to oxidized L p ( a), related to IgG (r=0.253 p=0.089). Analysis of patients relative to
the median of the studied parameters showed that the concentration of L p ( a) ≥12.3 mg / dL
increases the chances of rapid progression of coronary atherosclerosis after stenting by 2 times
(OR = 2.2 95% CI 0.6-7.6), as well as the absolute concentration of Th17 in the blood ≥11.5
thousand / ml (OR = 2.1, 95% CI 0.6-7.5). The combined increase in these parameters
potentiated the risk of rapid progression of coronary atherosclerosis by 4 times (OR = 4.2, 95%
CI 0.7-23.9). In the case of patients having both a Lp(a) concentration above 12.3 mg / dL and
an elevated titer of autoantibodies to Lp (a) or LDL in the blood plasma, the risk of developing
34 progressive atherosclerosis also increased (OR = 5.3, 95% CI 0.9-32.1 and OR = 6.0, 95% CI
1.0-37.3), respectively.
Conclusion.
Our work revealed that Lp ( a), T-helper 17 and autoantibodies to Lp ( a) and
LDL are associated with rapidly progressing coronary artery disease in patients with stable
coronary artery disease.
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Alisherovna SN et al. Course of Myocardial Infarction in Young Women //Eurasian
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