Koncentracija endotelne lipaze u serumu i funkcionalne značajke lipoproteina visoke gustoće u bolesnika s različitim kliničkim prezentacijama koronarne bolesti

doctoral thesis

• Title (english): Endothelial lipase serum levels and functional characteristics of high density lipoprotein in patients with different clinical presentations of coronary artery disease
• Author: Tomislava Bodrožić Džakić Poljak
• Mentor: Vesna Degoricija (mentor)
• Committee member: Lea Smirčić-Duvnjak (predsjednik povjerenstva)
• Committee member: Mislav Vrsalović (član povjerenstva)
• Committee member: Kristina Mlinac Jerković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-02-09, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Kardiovaskularne bolesti su vodeći uzrok pobola i smrtnosti u svijetu a veliku većinu čini koronarna bolest sa svojim posljedicama. Najučestalije kliničke prezentacije koronarne bolesti su akutni koronarni sindrom i stabilna angina pektoris, prema novoj nomenklaturi zvana, kronični koronarni sindrom. Uz sve bolje farmakointerventne metode liječenja koronarne bolesti bilježi se porast prevalencije ishemijske bolesti srca, a ukupni mortalitet je i dalje visok. Čimbenici rizika za aterosklerotsku bolest su već više desetljeća poznati ali se farmakoterapija u modificirajućim čimbenicima rizika nije pokazala visoko učinkovitom, posebice ako govorimo o dislipidemiji.
Cilj ovog istraživanja bio je odrediti razinu endotelne lipaze i ispitati funkcionalne karakteristike lipoproteina visoke gustoće (HDL-a) u bolesnika s akutnim i kroničnim koronarnim sindromom te ih međusobno usporediti. U istraživanju je sudjelovalo 187 bolesnika s akutnim koronarnim sindromom i 72 bolesnika sa stabilnom koronarnom bolešću.
Razina endotelne lipaze, efluks kolesterola i antioksidativna aktivnost HDL-a bili su statistički značajno viši u bolesnika s kroničnim koronarnim sindromom, odnosno stabilnom koronarnom bolešću. U ovoj skupini bolesnika razina EL ipak nije korelirala s težinom koronarne bolesti. U skupini bolesnika koji su se prezentirali s akutnim koronarnim sindromom razina IL-6 i protuupalna sposobnost HDL-a bila je značajno viša u odnosu na sCAD bolesnike. Jednako tako, bolesnici s AKS imali su više aterosklerozom zahvaćenih segmenata koronarnih arterija. Vrijednosti endotelne lipaze ≤ 193,81 pg/mL, uz specifičnost testa od 93,1% i osjetljivost od 37,4% kod bolesnika koji imaju bolove u prsištu mogle bi se koristiti kao isključni kriterij za postavljanje dijagnoze akutnog koronarnog sindroma.

Abstract (english)

Cardiovascular diseases are the leading causes of morbidity and mortality worldwide, with the vast majority being coronary diseases and their consequences. The most common clinical presentations of coronary disease are acute coronary syndrome and stable angina pectoris, now referred to as chronic coronary syndrome under the new nomenclature. Despite advances in pharmacointerventional methods for treating coronary heart disease, the prevalence of ischemic heart disease is increasing, but overall mortality remains high. Risk factors for atherosclerotic disease have been known for decades; however, pharmacotherapy has not proven highly effective in modifying risk factors, particularly in cases of dyslipidemia.
The aim of this research was to determine the level of endothelial lipase and examine the functional characteristics of high-density lipoproteins (HDL) in patients with acute and chronic coronary syndromes, and to compare these two groups. The study included 187 patients with acute coronary syndrome and 72 patients with stable coronary disease.
The levels of endothelial lipase, cholesterol efflux, and the antioxidant capacity of HDL were statistically significantly higher in patients with chronic coronary syndrome (stable coronary artery disease). However, in this group of patients, the level of endothelial lipase did not correlate with the severity of coronary disease. In the group of patients who presented with acute coronary syndrome, the level of IL-6 and the anti-inflammatory capacity of HDL were significantly higher compared to those with stable coronary artery disease. Additionally, patients with acute coronary syndrome had more coronary artery segments affected by atherosclerosis. Endothelial lipase values ≤ 193,81 pg/mL, with test specificity of 93,1% and sensitivity of 37,4% in patients with chest pain, could be used as an exclusion criterion for establishing the diagnosis of acute coronary syndrome.

• Keywords: Koronarna bolest; Antioksidansi; Interleukin-6; Akutni koronarni sindrom; Angina; stabilna; Kardiovaskularne bolesti; Prevalencija; Lipoproteini; HDL; Ateroskleroza; Kolesterol; Faktori rizika; Lipaza; Protuupalna sredstva; Dislipidemije
• Keywords (english): Coronary disease; Antioxidants; Interleukin-6; Acute coronary syndrome; Angina; stable; Cardiovascular diseases; Prevalence; Lipoproteins; HDL; Atherosclerosis; Cholesterol; Risk factors; Lipase; Anti-inflammatory agents; Dyslipidemias
• Language: croatian
• URN:NBN: urn:nbn:hr:105:005918
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 89 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-02-20 08:42:37