ОЦЕНКА СТРУКТУРНО-ФУНКЦИОНАЛЬНЫХ ИЗМЕНЕНИЙ БРАХИОЦЕФАЛЬНЫХ АРТЕРИЙ У БОЛЬНЫХ ХРОНИЧЕСКОЙ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА И ГЕТЕРОЗИГОТНОЙ СЕМЕЙНОЙ ГИПЕРХОЛЕСТЕРИНЕМИЕЙ С УЧЕТОМ УРОВНЯ PCSK-9 И ГЕНЕТИЧЕСКОГО ПОЛИМОРФИЗМА E670G ГЕНА PCSK-9

Objective: To study the structural and functional features of atherosclerosis of carotid arteries in patients with heterozygous familial hypercholesterolemia taking into account the level of PCSK-9 and genetic polymorphism E670G of the PCSK-9 gene. Material and methods. The study included 57 patients with chronic ischemic heart disease (CIHD) and familial heterozygous hypercholesterolemia (HеFH, group I). The comparison group consisted of 144 patients with SCAD without HeFH in the control group have been divided into two subgroups: A – statin free before the research (n = 63) and B (n = 81) who took it outpatiently; control group consisted of 17 healthy persons. Serum level of PCSK-9 was measured with «Human Proprotein Convertase 9/PCSK-9 ELISA Kit» (MULTI SCIENCE China). The genetic typing at PCSK-9 E670G (rs505151) polymorphism was performed by means of PCRRFLP method. Результаты. A comparison of the results of duplex scanning of carotid arteries in patients with HeFH showed that the thickness of the intima-media complex of the carotid arteries on the left (1,14 ± 0,18 mm, P < 0,01) and on the right (1,15 ± 0,16 mm, P < 0,01) was higher, than in the comparison group: 1,05 ± 0,17 mm and 1,04 ± 0,18 mm, respectively. The studies revealed a positive correlation between the incidence of MI in history in patients with the heterozygous familial hypercholesterolemia and the thickness of IMC of carotid arteries (r = 0,38, Р < 0,05). The latter also correlated with an increase in the concentration of PCSK-9 (r = 0,31, P < 0,05) in the blood and the carriage of the G allele of polymorphism E670G (r = 0,39, P < 0,05) of the PCSK-9 gene. Conclusion. In patients with heterozygous familial hypercholesterolemia have established a direct correlation between MI in history, the thickness of the IMC of carotid arteries, an increase of the concentration of PCSK-9 in the blood and the carriage of the G allele of polymorphism E670G of the PCSK-9 gene, that allows to using them as prognostic markers of risk of development of cardiovascular complications