Results of evaluation of biological and rheological parameters in patients after cholecystectomy

Background. Considering the change in the pathogenetic vector towards the studying of comorbidity, becomes crucial the search for biological predictors providing a more precise assessment of cardiovascular risk in specific subgroups of patients with moderate, unusual or undetectable risk levels (for example, in patients with background acute surgical diseases of the abdominal cavity).
Aim. Evaluation of some rheological and biochemical parameters in patients with acute calculous cholecystitis.
Material and methods. The main group consisted of patients with acute calculous cholecystitis, which were administered cardioprotective therapy (acetylsalicylic acid and atorvastatin) and who carried out urgent cholecystectomy (OKT group). The first comparison group was formed of patients who underwent urgent cholecystectomy, but did not took cardioprotective therapy (OK group). The second comparison group was formed of patients which were used cardioprotective therapy, but who did not perform cholecystectomy (KT group).
Results and discussion. In accordance the study, the following initial data were obtained (Me (25th; 75th percentiles)): HSCRP, mg/l – 9.6 (3.8;15) and 21.11 (4.90;18.20), p > 0.05; homocysteine, mmol/l 12.6 (8.6;16.3) and 9.04 (6.80;10.00), p < 0.05; ICAM-1, ng/ml – 420 (298;482) and 564.27 (280.00;920.00), p > 0.05; MMR-9, ng/ml 119.2(116;1430) and 991.36 (690;1450), p > 0.05, in the OKT and KT groups, respectively. The following data were obtained on an outpatient basis: HSCRP – 1.6 (0.88;3.56) and 5.94 (1.87;9.63), p < 0.05; MMP-9 – 108.5 (84.4;575) and 800.90 (465.00;1310.00), p < 0.05; ICAM-1 – 434.5 (340;580) and 277.75 (240.00;306.00), p < 0.05; homocysteine 14.9 (12.9;19.2) and 15.51 (14.10;18.25), p > 0.05, in the OKT and KT groups, respectively.
Conclusion. The absence of surgical treatment of acute calculous cholecystitis resulted in to significantly higher concentrations of markers of inflammation such as HSCRP, matrix metalloproteinase-9 and lowered levels of the intercellular adhesion molecule – ICAM-1. Thus, conservative management of patients with acute calculous cholecystitis was accompanied with higher concentrations of biomarkers of inflammation and atherosclerotic plaque vulnerability by the end of 30 days of follow-up.

1. Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR) / Massimo F. Piepoli [et al.] // Eur Heart J. – 2016. – Vol. 37, № 29. – P. 2315–2381.

2. Chen Y, Tao Y, Zhang L, et al Diagnostic and prognostic value of biomarkers in acute myocardial infarction. Postgraduate Medical Journal 2019;95:210-216

3. Oslyakova A. O., Tihomirova I. A. Sostoyanie mikrocirkulyatornogo rusla i gemoreologicheskij status v norme i pri narusheniyah koronarnogo krovoobrashcheniya / Yaroslavskij pedagogicheskij vestnik – 2012. – № 2. S. 103–108.

4. Sirs, J.A. The flow of human blood through capillary tubes / J.A. Sirs // J. Physiol. – 1991. – Vol. 442. – P. 569–583.

5. Plasma levels of TNF-alpha, IL-6, and IL-10 and their relationship with left ventricular diastolic function in patients with stable angina pectoris and preserved left ventricular systolic performance / W. Kosmala [et al.] // Coron. Artery Dis. – 2008. – Vol. 19, № 6. – P. 375–382.

6. Stepanova T. V., Ivanov A.N., Tereshkina N.E., Popyhova E.B., Lagutina D.D. Markery endotelial’noj disfunkcii: patogeneticheskaya rol’ i diagnosticheskoe znachenie (obzor literatury) // Klinicheskaya laboratornaya diagnostika. – 2019. – № 1. – C. 34–41.