Patients with coronary artery disease are at high risk of developing acute coronary syndrome, which is classified as a life-threatening event. Biological markers are extremely important in the diagnosis and prognosis of these patients, and help to determine size of the risk of an adverse cardiac event. Troponin is one of the most well-known biological markers of coronary artery disease. In addition, the value of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is often measured after a heart attack. Often, timely prediction of adverse events only with the use of previously known biological markers is not possible, thus according to the latest pathophysiological findings, new ones are constantly being discovered. Newer biological markers include ST2 (suppression of tumorigenicity 2), which is an indicator of the transformation of heart muscle and inflammation in various disease processes, often in coronary artery disease. For prognostic purposes, NT-proBNP and ST2 are used as independent indicators, however their predictive value increases when used together. To monitor and interpret the values of biological markers, it is important to know the possible effects on their values. The aim of our study was to examine the impact of various factors (two weeks of organized physical exercise, type of revascularization procedure, age, gender, and body mass index) on ST2 and NT-proBNP biomarkers in coronary artery disease patients two to four weeks after a heart attack or revascularization procedure. ST2 was not statistically proven to be associated with any of the factors studied, but elevated concentrations were observed in male population and in patients revascularized with coronary artery bypass graft, which is a more invasive procedure compared to percutaneous coronary intervention. Age and body mass index did not affect ST2 values. After a two-week organized exercise program, we were expecting a decrease in the values of both biological markers due to beneficial effects of physical exercise on blood vessels in patients with coronary artery disease. In ST2, a greater decrease was observed in the control group, i.e., in the group that did not participate in the two-week exercise program. In these participants, we monitored the physiological decline in ST2 levels after a cardiac event, and the two-week exercise program slowed this decline. For NT-proBNP, we were able to statistically prove the beneficial effect of a two-week exercise program on the measured values, as we measured lower values of the biological marker after two weeks. In addition, higher values were observed for NT-proBNP in women, elderly individuals, and individuals with a lower body mass index.
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