Serum Fas/FasL levels in dependence on clinical presentations of coronary disease and their relationship with risk factors Koncentracije Fas/FasL u zavisnosti od kliničke prezentacije koronarne bolesti i njihov odnos sa faktorima rizika

Background/Aim. Ischemic heart disease is mostly a consequence of atherosclerosis. Besides the inflammation, the Fas/Fas ligand (FasL)/caspase death pathway is documented to be activated in atherosclerotic lesions. The aim of this study was to compare the values of soluble forms of Fas and FasL in patients with different presentations of coronary disease and to correlate Fas/FasL with risk factors. Methods. We studied 30 patients with chronic stable angina pectoris (SAP), 27 with non-stable angina pectoris (NSAP), and 39 with acute ST-elevation myocardial infarction (STEMI) and 27 age-matched healthy volunteers (the control group). Serum Fas/APO1 and FasL concentrations were determined using a commercially available enzymelinked immunoassays (ELISA). Results. Fas/APO-1 levels in the STEMI patients (6.981 ± 2.689 ng/mL) were significantly higher than Fas levels in the controls (5.092 ± 1.252 ng/mL, p < 0.01), but not significantly higher than Fas values in the SAP (5.952 ± 2.069 ng/mL) and the USAP patients (5.627±2.270 ng/ml). Levels of FasL did not show any significant difference among the studied groups. In the SAP patients Fas/APO1 showed a significant positive correlation with high sensitivity C-reactive protein (hsCRP) (p < 0.05) and a negative correlation with high-density lipoprotein cholesterol (HDL-C) (p < 0.05), while FasL showed a significant positive correlation with low-density lipoprotein cholesterol (LDL-C) (p < 0.05). Fas levels between the patients having cholesterol within normal range and those whose cholesterol was above the normal range showed a significant difference (p < 0.05) only in the NSAP patients. Fas and FasL levels between the patients with hsCRP lower than 3.0 mg/L and those with hsCRP higher than 3.0 mg/L of the SAP group showed a significant differences (p < 0.001, p < 0.05, respectively). Strong correlation between Fas concentration and diabetes mellitus (p < 0.05) and FasL concentrations and both cholesterol (p < 0.01) and triglycerides (p < 0.01) in the NSAP patients was observed. The patients in the SAP group showed no strong correlation between Fas and FasL concentration and risk factors. Conclusions. The obtained results showed that apoptotic process is dysregulated in the patients with ischemic heart disease. Interdependence between Fas and FasL and inflammatory and lipid markers as well as with cardiovascular risk factors was established.