Динаміка рівня ендотеліального моноцитактивуючого пептиду-ІІ у хворих на гострий інфаркт міокарда з супутнім цукровим діабетом 2 типу

Abstract

The purpose of the study was to investigate the dynamics of endothelial monocyte activating polypeptide-ІІ in patients with acute myocardial infarction with concomitant diabetes mellitus type 2 six months after a coronary event. Materials and methods. 120 patients participated in the study: group 1 – patients with acute myocardial infarction with diabetes mellitus type 2 (n=70), group 2 – patients with acute myocardial infarction (n=50). The control group included 20 practically healthy people. All patients underwent laboratory and instrumental examination on the first day of acute myocardial infarction and 6 months after it. The level of endothelial monocyte activating polypeptide-ІІ was determined using the test system “Human Endothelial Monocyte Activating Polypeptide-ІІ ELISA KIT”. Results and discussion. The average level of endothelial monocyte activating polypeptide-ІІ on the first day of an acute myocardial infarction was: in patients who were part of the 1st group – 4.54 ± 0.331 ng/ml; 2nd – 2.74 ± 0.21 ng/ml; control group – 1.1 ± 0.037 ng/ml (р<0.05). In patients of the 1st group, half a year after acute myocardial infarction, the average level of endothelial monocyte activating polypeptide-ІІ was equal to 3.6 ± 0.11 ng/ml; 2nd – 2.28 ± 0.05 ng/ml (р<0.00001). Re-examination of patients, depending on treatment tactics, showed the following results: in patients with acute myocardial infarction with concomitant diabetes mellitus type 2 after cardiac ventriculography, the endothelial monocyte activating polypeptide-ІІ level was equal to 3.5 ± 0.04 ng/ml; in patients with acute myocardial infarction with concomitant diabetes mellitus type 2 after standard anticoagulant therapy it was 3.71 ± 0.03 ng/ml; in patients with isolated acute myocardial infarction after cardiac ventriculography – 2.24 ± 0.01 ng/ml; in patients with isolated acute myocardial infarction after standard anticoagulant therapy – 2.33 ± 0.04 (р<0.01). Conclusion. Endothelial monocyte activating polypeptide-ІІ is a marker of endothelial dysfunction that has prognostic properties in relation to comorbid pathology in the form of acute myocardial infarction with. diabetes mellitus type 2. In patients with an acute myocardial infarction in the presence of diabetes mellitus type 2, a higher level of endothelial monocyte activating polypeptide-ІІ was noted on the 1st day of a coronary event and 6 months after it, compared to patients with an isolated acute myocardial infarction and individuals of the control group (p<0.05). After cardiac ventriculography in patients, the level of endothelial monocyte activating polypeptide-ІІ was significantly lower compared to this indicator after standard anticoagulant therapy