PECULIARITIES OF THE POST-INFARCTION PERIOD CLINICAL COURSE IN PATIENTS WITH DIABETES MELLITUS TYPE II AFTER PERCUTANEOUS CORONARY INTERVENTION

Abstract

Aim – to define the parameters’ dynamics of carbohydrate, lipid, energy and adipokinemetabolism and the structural and functional state of the left ventricle (LV) myocardiumin patients with post-infarction cardiosclerosis and type 2 diabetes mellitus (DM).Materials and methods. 74 type 2 DM patients, who underwent myocardial infarction,were examined. The first subgroup comprised 20 patients, who received medicinaltherapy, and the second subgroup was composed of 50 patients who underwentpercutaneous coronary intervention (PCI). Serum levels of insulin, adropin, irisin, fattyacid binding protein 4 (FABP4) and C1q/tumor necrosis factor- related protein (CTRP3)were determined by enzyme- linked immunosorbent assay. Doppler echocardiographicexamination was performed using a Radmir ULTIMA Pro30 ultrasound scanner. Theresults were statistically analyzed using IBM SPPS software (version 27.0). A level ofp<0.05 was set for determining statistical significance.Results. Following parameters: end-diastolic volume (17,19% and 7,42% respectively),end-systolic volume (30,71% and 10,24% respectively), stroke volume (32,58% and10,61% respectively), iricin (37,57% and 79,89% respectively) increased and such indicesas insulin (46,70% and 58,03% respectively), glucose (35,24 and 39,81% respectively)decreased in patients with post-infarction cardiosclerosis and type 2 DM under conditionsof medicinal therapy in comparison with values of these indices in patients before thetreatment respectively (p<0,05). Following the treatment only with medicinal therapy,in patients with post-infarction cardiosclerosis and type 2 DM higher values of suchindicators as EDS 4.90%, LV PWT 16.67%, LA 18.42%, LVMM 7.77%, LVMMI 19.24%,have been determined, reliably lower value of diastolic arterial pressure – 16,19%,lipoproteins of low density – 5,90%, triglycerides – 13,30%, atherogenic coefficient –16,09%, adropin – 41.43%, FABP4-27.71%, CTRP3-32.91% were established underconditions of only PCI treatment in comparison with the values of those biochemicalparameters before the treatment, respectively, (p<0.05).Conclusions. 1. An increase of echocardiographic indicators, imbalance in energetic andadipokine metabolism have been found in patients with post-infarction cardiosclerosisand type 2 DM. 2. In patients under conditions of PCI structural- functional changes of LVmyocardium delay in comparison with those receiving only medicinal therapy.