[RELATIONSHIP BETWEEN SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE].

Aim: To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. Materials and methods: The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1ß, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. Results: 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1ß, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. Conclusion: Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.

[Pulmonary function in patients with type 2 diabetes and coronary artery disease].

Currently, there is no convincing evidence of respiratory failure in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Aim: To evaluate the differences in the main parameters of pulmonary function in patients with isolated type 2 diabetes and diabetic patients with CAD. Materials and methods: Patients with diabetes were allocated to two groups depending to the presence of CAD. The assessment of carbohydrate and lipid metabolism, as well as the measurement of inflammatory markers were performed using standard methods of clinical and biochemical analysis. Respiratory function and diffusion capacity of the lungs (DLCO) were assessed using a body plethysmograph Elite Dl-220v. Results: Main pulmonary functional test parameters were within normal values, except residual volume in diabetic patients. Patients with concomitant CAD demonstrated lower values of the studied parameters compared to non-diabetic ones. A number of volume and flow rate parameters as well as DLCO correlated with systemic inflammation, decompensation of carbohydrate and lipid metabolism, and duration of diabetes. Conclusion: Diabetic patients with CAD suffered from respiratory failure, manifested as decline in pulmonary function and DLCO. Blood glucose levels, inflammation symptoms, dyslipidemia and myocardial dysfunction are among suspected causes contributing to the development and acceleration of this decline.

[Prognostic role of C-reactive protein in progression of atherosclerosis in a year after coronary bypass surgery].

Aim of the study was to assess prognostic role of high sensitivity C-reactive protein (CRP) in progression of atherosclerosis in patients with ischemic heart disease (IHD) in a year after coronary artery bypass grafting (CABG). We examined 49 patients with stable IHD subjected to elective CABG (45 with and 4 without without cardiopulmonary bypass). In a year after surgery patients were divided into 2 groups: with (group 1, n=18, 36.7%) and without (group 2, n=31, 63.3%) progression of atherosclerosis of any localization. Contribution of various clinical and instrumental factors, type of intervention, CRP level before and in 1 year after surgery was analyzed. Before CABS CRP level was 3 times higher in group 1 compared with group 2 (=0.03). Increase of intima-media thickness was registered in a year after CABS in both groups, but it was significant only in patients with atherosclerosis progression (=0.04). Other clinical factors, gender characteristics of groups, type of intervention exerted no significant influence on progression of systemic atherosclerosis.