Résumé
This study was designed to detect the impact of apoptosis on prognosis and clinical outcome in patients with myocardial infarction [MI] and its relation to the other risk factors for coronary artery disease. Forty patients [22 males, 18 females] with mean age 53.88 +/- 1.39 years diagnosed as MI on the basis of electrocardiographic and enzymatic changes in addition to the clinical symptoms and signs. Twenty-two patients were smokers. Fifteen healthy volunteers were chosen as a control group. Patients group was classified according to infarct size [expensive MI 62.5%, localized MI 37.5%], presence or absence of heart failure [MI with HF 67.5%, MI without HF 32.5%], presence or absence of diabetes mellitus [DM] [MI with DM 46.5%, MI without DM 52.5%], presence or absence of hypertension [HTN] [MI with HTN 47.5%, MI without HTN 52.5%]. For every participant, history and clinical examination paying special attention to vital signs and cardiopulmonary examination, as well as resting electrocardiogram [ECG] looking for the changes of MI were done. In addition, the following laboratory investigations: Serum sugar, total cholesterol, triglycerides, soluble Apo-1/Fas, homocysteine and nitric oxide [NO] concentrations in serum were assessed. It was concluded that soluble Fas as a marker of myocardial apoptosis is strongly associated with and may be a major determinant of unfavorable early symptomatic post- infarction HF and is related to the size of MI. Homocysteine acts as an independent risk factor for atherosclerotic cardiovascular events and the decreased level of NO is associated with increased risk for development of atherosclerosis, HTN and symptomatic left ventricular [LV] dysfunction