TIME COURSE OF ENDOTHELIAL DYSFUNCTION AND ATHEROTHROMBOSIS MARKERS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH ST SEGMENT ELEVATION AND TYPE 2 DIABETES MELLITUS DEPENDING ON REPERFUSION THERAPY APPROACH

The aim: To evaluate the levels of plasminogen activator type 1 inhibitor, asymmetric dimethylarginine and endothelial nitric oxide synthase on day 10-14 in patients, depending on the presence or absence of concomitant type 2 diabetes and the type of reperfusion therapy. Materials and methods: The study involved 130 patients with acute myocardial infarction, divided into 2 groups: Group 1 consisted of patients with acute myocardial infarction with type 2 diabetes mellitus (n = 73), Group 2 comprised patients with acute type 2 diabetes mellitus (n = 57). The quantitative content of IAP-1 was determined by enzymelinked immunosorbent assay using a commercial test system manufactured by Technoclone PAI-1 ELISA Kit (Austria), NOS – Enzyme-Linked Immunosorbent Assay (ELISA) Kit for Nitric Oxide Synthase Endothelial (NOS) ADMA ELISA Kit (Austria). Results and conclusions: Percutaneous coronary intervention contributes to a significant reduction in the content of ADMA, which is a marker of endothelial dysfunction and increase NOS on the 10-14th day of acute myocardial infarction compared with standard therapy. During PCI, the level of IAP-1 did not significantly change in the time course of treatment due to post-inflammatory and post-traumatic activation of platelets in the vascular wall.

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Impact of Reperfusion Therapy on the Levels of Endothelial Nitric Oxide Synthase in Patients with Acute Myocardial Infarction and Type 2 Diabetes Mellitus

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.05.163 ◽

2021 ◽

Vol 6 (5) ◽

pp. 163-168

Author(s):

Т. S. Zaikina ◽

◽

D. V. Minukhina ◽

P. I. Rynchak ◽

G. Yu. Tytova ◽

...

Keyword(s):

Nitric Oxide ◽

Diabetes Mellitus ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Acute Myocardial Infarction ◽

Type 2 Diabetes Mellitus ◽

Endothelial Nitric Oxide Synthase ◽

Oxide Synthase ◽

Endothelial Nitric Oxide

The purpose of the study was to investigate the effect of reperfusion therapy on the levels of endothelial nitric oxide synthase in patients with acute myocardial infarction and concomitant type 2 diabetes mellitus. Materials and methods. The study involved patients with acute myocardial infarction, who were divided into groups depending on the presence of type 2 diabetes mellitus and the therapy performed for them: group 1 – 58 patients with acute myocardial infarction and diabetes mellitus who underwent percutaneous coronary intervention; group 2 – 15 patients with acute myocardial infarction and diabetes mellitus who underwent exclusively conservative treatment; group 3 – 40 patients with acute myocardial infarction without diabetes who underwent percutaneous coronary intervention; group 4 – 17 patients with acute myocardial infarction without diabetes, who underwent exclusively conservative treatment. Results and discussion. According to the obtained results, in patients with concomitant type 2 diabetes mellitus, significantly lower levels of endothelial nitric oxide synthase were revealed, compared with patients without disturbances in carbohydrate metabolism, which indicates deeper impairments of endothelial function against the background of hyperglycemia and insulin resistance. Analysis of the effect of reperfusion therapy showed a statistically significant increase in the level of endothelial nitric oxide synthase both in the group of patients with concomitant disorders of carbohydrate metabolism and without them, which indicates an improvement in the processes of endothelium-dependent dilation, regardless of the presence or absence of type 2 diabetes mellitus. The obtained results testify to the positive effect of percutaneous coronary intervention at the level of eNOS, which, in our opinion, will help to improve the vasodilating properties of vascular endothelium and prevent a complicated course of acute myocardial infarction. Conclusion. The patients with acute myocardial infarction and concomitant type 2 diabetes mellitus have significantly lower levels of endothelial nitric oxide synthase levels than patients without type 2 diabetes mellitus that indicates deep violations of endothelial function against background of metabolic changes associated with insulin resistance and hyperglycemia. Reperfusion therapy accelerates its restoration regardless of the presence or absence of type 2 diabetes mellitus

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