Interaction of asymmetric dimethylarginine, troponin I level, and diabetes mellitus 2 type severity in patients with acute myocardial infarction

Abstract

Introduction: The most important cause of mortality in the world is cardiovascular disease (CVD). Dysfunction of the endothelium is the initiating and exacerbating cause of atherosclerosis. Acute myocardial infarction (AMI) in patients with a history of diabetes mellitus (DM) leads to a higher mortality and severe disease course. Methods: The research design included 120 patients: Group 1 – AMI patients and concomitant DM type (n = 70) and Group 2 – AMI patients (n = 50) without concomitant DM type 2. 20 practically healthy persons were part of the reference groups. All patients were treated using instrumental and laboratory examinations in compliance with the current orders of the Ministry of Health of Ukraine. Results: The average level of ADMA on the first day of the AMI in patients of Group 1 was 1.57 ± 0.11 mmol/l; Group 2 – 0.61 ± 0.06 mmol/l; reference group – 0.17 ± 0.023 mmol/l (p1;2 < 0.00001, p1;3 < 0.001, p2;3 < 0.01). The average level of troponin I on the first day of the AMI in Group 1 was 4.89 ± 2.46 ng/ml; Group 2 – 2.67 ± 2.06 ng/ml; reference group – 0.06 ± 0.04 ng/ml (p1-2 < 0.00001, p1-3 < 0.00001, p2-3 < 0.00001). The direct marked correlation between ADMA and troponin I levels was revealed in the course of the correlation analysis (r = 0.687; p < 0.05). Conclusion: Asymmetric dimethylarginine is concluded to act as a marker of endothelial dysfunction. This has a high diagnostic value in cases of the acute myocardial infarction, especially where the patients have diabetes mellitus type 2. The research revealed the hyperactivity of troponin I in patients with the examined comorbid pathology. In the course of the correlation analysis, a direct marked correlation was revealed between the levels of asymmetric dimethylarginine and troponin I (p < 0.05). Correlation analysis between the marker of endothelial dysfunction and the marker of myocardial damage in the patients in Group 1 as per the form of diabetes mellitus type 2 demonstrated a direct marked correlation in the case of a mild form of carbohydrate metabolism disorder and a strong correlation in the case of moderate and severe forms of carbohydrate metabolism disorder.