INTRODUCCIÓN: REVISIÓN CRITICA DEL PROBLEMA

RESULTADOS
Additionally, we observed that sRAGE and fluorescent AGE levels were higher in
patients with atrial fibrillation as compared with those in sinus rhythm (1562.2 vs.
1051.3 pg/mL for sRAGE, P = 0.015 and 72.8 vs. 61.6 AU for fluorescent AGE, P
= 0.018).
Discussion
Several conclusions may be derived from the current study. First, we have
demonstrated that plasma levels of sRAGE, but not the AGEs evaluated in this
study (fluorescent AGE and glycated albumin) are correlated with ischaemic heart
disease in ambulatory HF patients, independently of age, sex, diabetes, renal
function, clinical severity or other confounding variables. Moreover, sRAGE was
directly associated with extent of coronary artery disease, but the same could not
be said for the AGEs evaluated. We also confirmed the previously observed
correlation between sRAGE and severity of HF, whereby sRAGE plasma levels
are higher in patients with a higher NYHA dyspnoea class and/or higher BNP
levels, although in the current study we did not find any significant correlation
between these variables and AGE levels. We found a direct and statistically
significant correlation between fluorescent AGE and glycated albumin, and a non
significant tendency towards a positive correlation between fluorescent AGE and
sRAGE. Finally, AGE–RAGE was significantly associated with plasma
fructosamine levels, but not with other diabetes-related parameters such as
glycated haemoglobin or fasting glycaemia. The current study also shows for the
first time, a direct correlation between sRAGE and ischaemic cardiomyopathy as
well as with the extent of coronary artery disease in HF patients, suggesting that
the soluble AGE receptor could play a role in the pathophysiology of HF.
The involvement of RAGE in the initiation and progression of vascular
atherosclerotic disease has been widely demonstrated in both animal and human
studies 282,284 . While cell-surface RAGE has been shown to be up-regulated and
co-localized with inflammatory markers in atherosclerotic plaques 170 , sRAGE has
been found to slow progression of atherosclerosis 169 AGE cross-link breakers
119