N-terminal and C-terminal fragments of IGFBP-4 as novel biomarkers for short-term risk assessment of major adverse cardiac events in patients presenting with ischemia.

OBJECTIVES: Pregnancy Associated Plasma Protein A (PAPP-A)-derived N- and C-terminal fragments of IGF-binding protein-4 (NT- and CT-IGFBP-4) released from vulnerable atherosclerotic plaques are proposed to be used for cardiovascular risk assessment. DESIGN AND METHODS: NT- and CT-IGFBP-4 were measured by novel immunoassays in EDTA-plasma of 180 patients admitted to the emergency department with symptoms of myocardial ischemia but without ST-segment elevation. Six-month incidence of major adverse cardiac events (MACE), including myocardial infarction, cardiac death, percutaneous coronary interventions, and coronary artery bypass grafting was recorded. RESULTS: Sixteen patients met the endpoint. NT- and CT-IGFBP-4 were strong predictors of MACE: area under ROC curve (AUC) 0.856 and 0.809, respectively. NT-IGFBP-4 concentrations≥214µg/L and CT-IGFBP-4 concentrations≥124µg/L were associated with increased risk of future MACE: adjusted hazard ratio 13.79 and 7.93, respectively. CONCLUSIONS: IGFBP-4 fragments can be utilized as biomarkers for MACE prediction in patients with suspected myocardial ischemia.

[Changes of the EEG capacity observed in certain pathologies of the central nervous system and in pain]. / Izmeneniia spektrov moshchnosti élektroéntsefalogrammy pri nekotorykh vidakh patologii TsNS i pri boli.

Published data on changing spectra of electroencephalograms (EEG), as observed in different pathological hypoxic conditions (hypoxia, ischemia of the brain, aging) were analyzed; changing EEG spectra were experimentally studied in pain. The EEG changes were found to be identical in all cases. At the very beginning of a pathological factor onset, there was an increasing dominating peak of the EEG spectrum (or, the beta2-frequency range was going up--stage I). Then, the spectral distribution began to shift gradually to the low-frequency region: the frequency-predominant rhythm was slowing down; the slow-wave region was increasing and the fast-wave EEG part (II, III) was decreasing. Affections in pain fit the limits of I and II and, sometimes, III stages. In hypoxia and ischemia, a new stage of changes (IV) developed later: there emerged, in EEG, a peculiar high-amplitude rhythmic "burst-type" activity, which preconditioned a specific pattern of the EEG spectrum (the discussed stage is hard to detect in aging). The above stage is critical for the body. The total EEG capacity sharply dropped after its onset in hypoxia, ischemia and aging and the bioelectric activity was made up only of scanty slow waves (V). The described changing EEG spectra develop at an increasing total spectrum capacity (hypoxia), at capacity decrease (ischemia and aging) or it does not change altogether (pain). The homogeneous changes of EEG spectra in the above pathophysiological conditions make it possible to conclude that they denote a gradual progression of a change in brain functioning. It was suggested that such change is related with a slowing general velocity in brain functioning.

[Neurophysiological analysis of the effects of antihypoxic versus psychotropic agents]. / Neirofiziologicheskii analiz deistviia antigipoksantov v sravnenii s psikhotropnymi sredstvami.

The Fourie EEG spectral analysis of thr sensomotor cortex and dorsal hypocampus in freely moving rats could reveal the common pharmacological EEG effects of different antihypoxic agents (gutimin, amtizole, emoxipine, and 3-OPK). All the agents decreased the total EEG power (they all reduced the absolute power in all frequency bands) and simultaneously enhanced (2 relative power. The former suggests that there was a decrease in the energetic level of bioelectric fluctuations, which may indicate that the brain reduces its energetic functioning level. The latter means that antihypoxic drugs activate the central nervous system. This effect may normalize EEG activity during hypoxic conditions, which causes the enhancement of slow-wave activity and reduces fast EEG activity. The pharmacological EEG effects of different groups of psychotropic drugs (nootropic drugs, psychostimulants, antidepressants, benzodiazepine tranquilizers, etc.) versus antihypoxants are discussed.