Biomarker diagnostics of endothelial dysfunction in patients with acute coronary syndrome and non-alcoholic fatty liver disease

Aim: To determine the severity of endothelial dysfunction (ED) in patients with acute coronary syndromes (ACS) in non-alcoholic fatty liver disease (NAFLD). Materials and Methods: The study included 124 patients with ACS. Group 1 included 74 patients after ACS and NAFLD, and group 2 consisted of 50 patients after ACS without liver damage. The patients' ED was determined in a test with reactive hyperaemia, and the levels of endothelin-1 (ET-1), P-selectin, and von Willebrand factor (wWF) were determined. Results: The reactive hyperaemia test revealed ED in patients with ACS regardless of liver damage. More pronounced changes in EDV and EIVD were found in patients with ACS in combination with NAFLD. Laboratory markers of ED, namely ET-1, P-selectin and WwF, were also significantly higher in patients with ACS and confirm the pronounced vasoconstrictor effect of endothelial dysregulation in these patients. A significant difference was found between the levels of ET-1, P-selectin and WwF in patients of groups 1 and 2. Conclusions: ED is established in patients with ACS, which is more pronounced in NAFLD. Biomarkers such as ET-1, WwF, P-selectin in the blood serum are highly specific substances for determining the severity of ED in patients with ACS, especially when it is combined with NAFLD.