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LEUKOCYTE INDICATORS OF INFLAMMATORY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND TYPE 2 DIABETES MELLITUS

https://doi.org/10.57256/2949-0715-2023-3-34-36

Abstract

Introduction. Acute myocardial infarction is accompanied by an intense inflammatory response. On the other hand, the severity of inflammation is a marker of the risk of poor prognosis. Type 2 diabetes mellitus (DM2) is associated with the development of chronic inflammation and oxidative stress.

Objective: To conduct a comparative analysis of leukocyte indicators of inflammation and highly sensitive C-reactive protein (hsCRP) in patients with ST-segment elevation acute myocardial infarction (STEMI) with and without DM 2.

Materials and methods. Inclusion criteria: men and women with STEMI with or without type 2 diabetes, age over 45 years, primary percutaneous coronary intervention (PCI). Exclusion criteria: cases of hospital mortality, acute heart failure according to Killip 3-4 at admission. The study included 30 patients with STEMI in combination with type 2 diabetes and 30 patients with STEMI without type 2 diabetes. The groups were matched by sex (15 men and 15 women in each group) and age (64.2 vs 63.8 years, p= 0.8049). In both groups, we compared leukocyte indicators of inflammation (the number of leukocytes, neutrophils, lymphocytes, neutrophil-lymphocyte ratio (NLO) and hsCRP before pcCI, as well as their dynamics on days 5–7 after pcCI. The study of the cellular composition of blood was performed on a hematological analyzer BC- 6800Plus, Mindray, China.HsCRP was determined by the method of biochemical analysis of blood on the analyzer BS-200, Mindray, China.Data are presented as mean (M) and standard deviation (SD).The distribution of variables was normal, therefore, to compare quantitative indicators in independent and in paired samples, Student's t-test was used, and Pearson's chi-square, 2 test was used to compare lesion locations in study groups.

Results. Body mass index was higher in the STEMI group with type 2 diabetes (30.2 kg/m2 and 26.6 kg/m2, p = 0.001). Groups of patients with and without type 2 diabetes did not differ in the incidence of anterior STEMI (43.3% and 56.6%; p2 =0.302), left ventricular ejection fraction 46.4% and 47.3%, p=0.399) . In the study groups with STEMI and DM 2 and without DM 2, such indicators as leukocytes (14.66±2.07×109/l vs 10.19±1.08×109/l, p<0.001) and (13, 92±1.73×109/L vs 9.81±1.77×109/L, p<0.001), neutrophils (8.64±1.2×109/L vs 5.36±0.97×109 /l, p<0.001) and (7.99±0.76×109/l vs 5.01±0.75×109/l, p<0.001), UFO (5.34±1.34 vs 2, 92±0.81, p<0.001) and (4.71±0.89 vs 2.75±0.96, p<0.001) and hsCRP (27.97±6.87 mg/l vs 13.23± 3.57 mg/l, p<0.001) and (29.86±5.91 mg/l vs 11.63±3.48 mg/l, p<0.001) decreased statistically significantly on days 5–7 of treatment in both groups, respectively. Lymphocytes (1.68±0.33×109/L vs 1.92±0.42×109/L, p<0.001) and (1.74±0.29×109/L vs 1.95±0, 45×109/l, p<0.001) in dynamics significantly increased in both groups, respectively. An intergroup comparative analysis showed that the degree of change in UFO at admission (5.34±1.34 vs 4.71±0.89, p=0.038) was statistically greater in the group with STEMI and DM 2. HsCRP decreased over time to a greater extent in the group with STEMI without DM 2 (-14.74±5.33 mg/l vs -18.23±5.25 mg/l, p=0.013). Upon admission, neutrophils (8.64±1.20×109/L vs 7.99±0.76×109/L, p=0.015) and UFOs (5.34±1.34 vs 4.71±0.89 , p=0.038) was statistically higher in the STEMI group with DM 2 than in the STEMI group without DM 2, respectively.

Conclusions: In both groups, all studied leukocyte indicators of inflammation, with the exception of monocytes, decreased by 5-7 days from the moment of admission. In patients with STEMI and type 2 DM, there was a significant increase in the level of neutrophils and UFO at admission and a slower dynamics of the decrease in hsCRP, compared with the group of patients with STEMI and without type 2 DM, which indicates a more pronounced inflammatory response associated with acute infarction in type 2 DM myocardium.

About the Authors

Ivan Fedorovich Bokovikov
GBUZ Irkutsk Order "Badge of Honor" Regional Clinical Hospital, Irkutsk; Irkutsk State Medical Academy of Postgraduate Education - – Branch Campus of the FSBEI FPE RMACPE MOH Russia, Irkutsk
Russian Federation


Konstantin Viktorovich Protasov
Irkutsk State Medical Academy of Postgraduate Education - – Branch Campus of the FSBEI FPE RMACPE MOH Russia, Irkutsk
Russian Federation


Natalia Anatolievna Khramtsova
GBUZ Irkutsk Order "Badge of Honor" Regional Clinical Hospital, Irkutsk Irkutsk State Medical Academy of Postgraduate Education - – Branch Campus of the FSBEI FPE RMACPE MOH Russia, Irkutsk
Russian Federation


Review

For citations:


Bokovikov I.F., Protasov K.V., Khramtsova N.A. LEUKOCYTE INDICATORS OF INFLAMMATORY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND TYPE 2 DIABETES MELLITUS. Baikal Medical Journal. 2023;2(3):34-36. (In Russ.) https://doi.org/10.57256/2949-0715-2023-3-34-36

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ISSN 2949-0715 (Online)

Irkutsk State Medical University

Irkutsk Scientific Center for Surgery and Traumatology