Introduction:Early complications of acute myocardial infarction (AMI) are one of the leading causes of death among patients with type 2 diabetes mellitus (DM). Clinical and laboratory characteristics and noninvasive methods need to be integrated to better identify early complications of AMI and further develop a treatment strategy. The aim of the study was to predict the development of early complications after AMI in type 2 DM patients, which could improve the quality of preventive and curative measures for this group of patients. Methods: In total, 109 patients with ST-elevation myocardial infarction (STEMI) and type 2 DM were included in the study: 75 men and 34 women. The training set (n = 74) was selected to study variables associated with the probability of early complications after AMI in type 2 DM patients. The model reproducibility was then checked on the validation set (n = 35). All patients underwent percutaneous coronary intervention (PCI). The training set identified 26 patients with early complications and 48 patients without early complications of AMI. The validation set identified 18 patients with early complications and 17 patients without early complications of AMI. The model for predicting early AMI complications was calculated using binary logistic regression. Results: The developed mathematical model for predicting early complications of AMI was as follows: Р = [1+ exp(-(0.030 × C1q tumor necrosis factor-related protein 3 (CTRP 3) (ng/ml) + 1.414 × respiratory rate (RR) (breaths per minute) + 0.322 × body mass index (BMI) (kg/m2) + 0.091× heart rate (HR) (beats per minute) -50.800))] −1 . The model yielded the highest results under the receiver operating characteristic curve for predicting early complications of AMI among the diabetic patients in both the training and validation groups (0.962 and 0.928, respectively). Conclusions : This study has shown that integral measurements of circulating CTRP 3 content, RR, BMI, and HR upon admission of STEMI patients with type 2 DM after PCI could predict early complications of AMI. These findings suggest a new approach to stratify the risk of early AMI complications in type 2 DM patients after successful coronary revascularization.

Abstract. Introduction. Nowadays, it becomes topical to search for methods of diagnosis and treatment for polymorbid patients. The importance of the study on pathophysiological mechanisms of acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (DM) has been shown. The aim of the study: to examine the relationship between adipokine and lipid profiles in AMI patients with the presence or absence of type 2 DM. Material and methods. The study was conducted over a period from September 1, 2018 to December 31, 2020. A total of 134 patients with ST-segment elevation AMI in the presence or absence of type 2 DM aged 58.97 ± 7.92 years hospitalized in the intensive care unit of Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” and Kharkiv Railway Clinical Hospital No. 1 of the branch “Center of Healthcare” were enrolled in the study. Group 1 included 74 patients with AMI and type 2 DM aged 59.42 ± 7.66 years. Group 2 (comparison group) comprised 60 patients with AMI without type 2 DM aged 58.42 ± 8.25 years. The control group consisted of 20 otherwise healthy individuals. Serum concentrations of fatty acid-binding protein 4 (FABP4) and C1q/TNF-related protein 3 (CTRP3) of patients were measured by enzyme-linked immunosorbent assay. Serum total cholesterol (TC) and high-density lipoprotein (HDL) cholesterol were analyzed by peroxidase enzymatic method. Triglyceride (TG) levels were measured by enzymatic colorimetric method. The atherogenic index was calculated by the A.M. Klimov formula. The levels of very low-density lipoprotein (VLDL) cholesterol and low-density lipoprotein (LDL) cholesterol were estimated by the Friedewald formula. Results and discussion. The patients in Group 1 were found to have higher levels of serum TG in comparison with Group 2 patients (р<0.05). In groups 1 and 2, there was an upward tendency in the levels of TC and LDL (р ˃0.05), as well as a significant 4.04 and 2.92 times increase in VLDL, respectively, as compared to the control group (p<0.05). The serum levels of FABP4 were significantly increased, while CTRP3 levels were decreased in AMI patients compared to those in otherwise healthy individuals (р<0.05). In AMI patients with type 2 DM (group 1), an inverse correlation was found between FABP4 and VLDL (r = 0.502, p<0.05), TG (r = 0.596, p<0.001); between CTRP3 and TC (r = -0.507, p<0.05), LDL (r = -0.512, p<0.05). In patients with AMI (group 2), an inverse correlation was revealed between FABP4 and VLDL (r = 0.453, p = 0.006), TG (r = 0.439, p = 0.009); between CTRP3 and TC (r = -0.413, p = 0.001), LDL (r = -0.429, p = 0.01). Conclusions. The characteristics of changes in the FABP4 and CTRP3 serum levels are evidence of an adipokine metabolism imbalance in AMI with the presence or absence of type 2 DM, indicating a metabolic shift in this patient category. The relationship between lipid profile markers and FABP4 and CTRP3 may indicate the influence of the latter on lipid metabolism.

BACKGROUND: Acute heart failure (AHF) is one of the early complications of acute myocardial infarction (AMI) in diabetic patients. Evaluation of biomarkers of energy and adipokine metabolism can help in the early identification of diabetic patients at risk of AHF. AIM: The present study is aimed to predict the development of AHF in diabetic patients with AMI based on energy and adipokine metabolism parameters. METHODS: A total of 74 diabetic patients with AMI were examined between September 1, 2018, and December 31, 2020. Serum adropin, irisin, and C1q/TNF-related protein 3 (CTRP3) levels were measured by enzyme-linked immunosorbent assay. To predict AHF development in AMI patients, generalized linear mixed model (GLMM) was applied. RESULTS: The serum concentrations of adropin, irisin, and CTRP3 have been found to be reduced in diabetic patients with AMI and AHF. The accuracy of predicting AHF Killip Class 1 was 96.7%, and the accuracy of prediction for AHF Killip Class 2 was 57.1%, that is, the model was poorly sensitive to this level of complications. The prediction accuracy for AHF Killip Class 3 was 80%, that is, the model was highly sensitive to complications of this level, and for AHF Killip Class 4 – 100% being the maximum level of the model sensitivity. CONCLUSIONS: Low serum concentrations of adropin, irisin, and CTRP3 indicate an imbalance in energy and adipokine homeostasis. The constructed model predicts the probability of AHF development with high accuracy of 91.9% in diabetic patients with AMI.

The article highlights the influence of matrix metalloproteinases, tissue inhibitors of metalloproteinases and tenascin C onto development and severity of the acute myocardial infarction in the patients with comorbide pathology. It was determined that the levels of matrix metalloproteinases were decreasing, and tissue inhibitors of metalloproteinases were raising in the patients with cardiovascular disease depending on the presence or absence of diabetes mellitus type 2. The attention was compelled to the ability of the extracellular matrix indicators to implement remodeling of the left ventricular myocardium in the patients with acute myocardial infarction and its complications. Here was exposed the changes in the parameters of the patients that have confirmed a promising study of their predicting properties at the development of cardiovascular complications in the patients with the acute myocardial infarction with concomitant diabetes mellitus type 2.

Annotation. The study on the metabolic profile in the long-term period after myocardial infarction with comorbidity is relevant. The aim of the work was to examine metabolic profile and echocardiographic parameters in patients with ST-elevation myocardial infarction (STEMI) and obesity following percutaneous coronary intervention (PCI) after a 1-year follow-up. A total of 60 patients with STEMI and obesity were examined. The first subgroup consisted of 20 patients with medicamentous therapy, and the second group – 38 patients with PCI. Adropin, irisin, fatty acid-binding protein 4 (FABP4), C1q/tumor necrosis factor-related protein-3 (CTRP3) were measured by the enzyme-linked immunosorbent assay. The statistical processing of the study results obtained was carried out using the software package “IBM SPPS Statistics 27.0”. The following parameters were increased in patients who received combined medicamentous and PCI therapy before and after the treatment (p<0.05): end-diastolic size (EDS) (by 16.83% and 10.89%, respectively), end-diastolic volume (EDV) (by 45.95% and 18.92% respectively), end-systolic volume (ESV) (by 40.0% and 27.69%, respectively), stroke volume (SV) (by 33.85% and 18.46%, respectively), left ventricular myocardial mass index (LVMMI) (by 18.93% and 10.06%, respectively), adropin (by 27.13% and 47.21%, respectively), irisin (by 2.07 times and 2.75 times, respectively) and CTRP3 (by 15.98 % and 31.96%, respectively), while the following parameters were decreased: systolic blood pressure (by 16.0% and 16.67%, respectively), diastolic blood pressure (by 15.56% and 14.44%, respectively), insulin (by 40 .38% and 48.59%, respectively), glucose (by 10.97% and 15.74%, respectively), atherogenic index (by 6.03% and 12.33%, respectively). Thus, patients with post-infarction cardiosclerosis and obesity have been revealed with increased echocardiographic parameters and imbalanced energy and adipokine metabolism.