Маркери ендотеліальної дисфункції як предиктори ускладненого перебігу гострого інфаркту міокарда у поєднанні з цукровим діабетом 2 типу

Abstract

Today, the endothelium is considered to be a multifunctional organ and a non-specific marker in the pathogenesis of diseases of the cardiovascular system. The course of diseases of the cardiovascular system depends on the presence of comorbid pathology, where type 2 diabetes is one of the possible representations of such pathology. The purpose of the study was to determine the diagnostic role of marker of endothelial dysfunction in patients with acute myocardial infarction with concomitant type 2 diabetes mellitus with regard to the clinical course of comorbid conditions. Material and methods. The study design consisted of 120 patients. They were divided into 2 groups: Group 1 consisted of patients with acute myocardial infarction and concomitant type 2 diabetes (n=69), Group 2 consisted of patients with acute myocardial infarction without concomitant type 2 diabetes (n=51). Patients of both groups matched on age and sex (60 men (50%) and 60 women (50%); their average age was 66.35±0.91 years, р<0,05). The control group consisted of 20 almost healthy people, among them 12 women (60%) and 8 men (40%) (average age was equal to 45.17±2.88 years). Examination of patients was conducted on the basis of Municipal Non-profit Enterprise "City Clinical Hospital No. 27" of Kharkiv City Council in the department of cardiology for patients with acute myocardial infarction. Diagnoses were determined according to the current criteria. All patients enrolled in the study signed a voluntary informed consent to participate in it. All patients underwent general clinical and instrumental examinations. The level of endothelial monocyte-activating polypeptide II in participants of the study was determined on the first day of acute myocardial infarction by using a commercial test system "Human Endothelial monocyte activating polepeptide II ELISA KIT". Results and discussion. According to the results of the study, in patients with acute myocardial infarction in combination with type 2 diabetes the levels of endothelial monocyte-activating polypeptide II was higher than in patients without concomitant type 2 diabetes by 1.65 times (p <0.05). The course of the study revealed the level of endothelial monocyte-activating polypeptide II, which was marked by high risk of cardiogenic shock and acute left ventricular failure. Having analyzed the parameter of endothelial dysfunction in terms of mortality, the researchers made the following conclusion: the endothelial monocyte-activating polypeptide II values greater than 3.44 ng/ml were the predictor of cardiovascular death probability during 6 months. Conclusion. The results of analysis of endothelial function made with use of the marker of endothelial monocyte-activating polypeptide II in patients with acute myocardial infarction with concomitant type 2 diabetes showed that such indicator can be deemed as predictor in complicated comorbid conditions