Correlation between Carbonic Anhydrase Isozymes and the Evolution of Myocardial Infarction in Diabetic Patients.

Abstract

Simple SummaryHeart disease in diabetics presents distinctive characteristics both anatomically and physiopathologically compared to non-diabetics. In people with diabetes, high blood pressure has a high incidence (approximately one-third of diabetic patients have high blood pressure) and is a risk factor for diabetic macro- and microvascular complications. The correlation of these parameters could represent early markers of the prognosis and evolution of diabetic patients with acute myocardial infarction and their routine determination could be included in the biological algorithm of acute myocardial infarction, but understanding of this aspect must be deepened in the future. The results showed that diabetic patients develop acute myocardial infarction more frequently, regardless of age. The level of the enzymes of myocardial necrosis was higher in diabetics compared to non-diabetics, and acute coronary syndrome occurs mainly in diabetics with inadequate metabolic balance. Our research may provide useful information for the medical community.(1) Background: Myocardial infarction was, until recently, recognized as a major coronary event, often fatal, with major implications for survivors. According to some authors, diabetes mellitus is an important atherogenic risk factor with cardiac determinations underlying the definition of the so-called “diabetic heart”. The present study aims to establish a correlation between the evolution of myocardial infarction in diabetic patients, by determining whether lactic acid levels, the activity of carbonic anhydrase isoenzymes, and the magnitude of ST-segment elevation are correlated with the subsequent evolution of myocardial infarction. (2) Methods: The study analyzed 2 groups of 30 patients each: group 1 consisted of diabetic patients with acute myocardial infarction, and group 2 consisted of non-diabetic patients with acute myocardial infarction. Patients were examined clinically and paraclinical, their heart markers, lactic acid, and the activity of carbonic anhydrase I and II isozymes were determined. All patients underwent electrocardiogram and echocardiography analyses. (3) Results: The results showed that diabetics develop acute myocardial infarction more frequently, regardless of how much time has passed since the diagnosis. The value of myocardial necrosis enzymes was higher in diabetics than in non-diabetics, and acute coronary syndrome occurs mainly in diabetics with poor metabolic balance. Lethality rates in non-diabetic patients with lactic acid values above normal are lower than in diabetics. (4) Conclusions: Lactic acid correlated with the activity of isozyme I of carbonic dioxide which could be early markers of the prognosis and evolution of diabetic patients with acute myocardial infarction.