ESTIMATION OF PURINE CATABOLISM IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Introduction: The issue of searching of modern markers of early diagnosis and progression of coronary heart disease and its complications is very actual. The analysis of the literature showed that the achievements of modern biochemistry prove conclusively the role of purine metabolism disorders in the pathogenesis of various diseases, the development and progression of it previously not considered in the context of their relationship with the purine metabolism changes. The results of earlier studies on this problem are quite contradictory. This necessitates further estimation of the full spectrum of purine catabolites in the development of acute myocardial infarction, which was the aim of this study. Case presentation: In this study 315 individuals aged 40-75 with verified diagnosis of ischemic heart disease was examined. 123 of them had acute myocardial infarction, in other 192 cases unstable angina pectories has been verified. Purines and its intermediates, guanine, hypoxanthine, adenine, xanthine and uric acid were determined in blood plasma and in erythrocytes with direct spectrophotometry according to method. In the result of this study in the group of patients with acute miocardial infarction, statistically significant elevation in the concentrations of adenine (p = 0.04) hypoxanthine and uric acid (p = 0.02) in comparison with the reference values and in comparisson with the patients with unstable angina pectories were determined. On guanine and xanthine concentrations in the patients from this group, the statistically significant differences were not determined. During evaluation of the purine catabolism of blood erythrocytes statistically significant differences between study groups were not found. Conclusion: The predominant accumulation of extracellular concentration of adenine, hypoxanthine and uric acid in patients with acute myocardial infarction were established in this investigation. This trend can be used as the early diagnostic biochemical marker of cardiomyocytes necrosis, along with the determination of previously studied.