Background. The processes of inflammation and repair in the area of myocardial infarction (MI) are carried out and regulated by various populations of immune cells, including monocytes, lymphocytes, and NK-cells. The success of myocardial recovery after infarction and the risk of developing acute heart failure (AHF) depend on their adequate interaction. The presence of type 2 diabetes mellitus (T2DM), in which chronic low-gradient inflammation occurs, can affect the monocytic and lymphocytic response in MI, which may contribute to the development of AHF.Objective. to assess the features of monocytic and lymphocytic responses in patients with MI T2DM complicated by the development of AHF.Design and methods. The study included 121 patients with MI T2DM (38 of them with AHF). The control group included 59 patients without diabetes mellitus (including 13 patients with AHF). For all patients within 1 day, on days 3, 5 and 12 of MI, the total number of monocytes and lymphocytes, the monocytes-to-lymphocytes ratio (MLR), subpopulations of monocytes and T-lymphocytes with NK cells (T&NK-cells) were determined by flow cytometry.Results. In patients with T2DM, the number of monocytes of different subpopulations did not differ depending on the development of AHF. In patients without T2DM with MI, complicated by AHF, compared with patients without AHF, on day 3, the number of CD14(+)CD16(-)monocytes was higher: 1018 (824; 1144) vs 593 (557; 677) cells/μL, p <0,01, and on days 3 and 5, the number of CD16(+) T&NK-cells was lower: 122 (95; 275) cells/μL and 307 (220; 406) cells/μL, respectively (p = 0,03); (117 (61; 228) and 437 (408; 545) cells/μL, respectively, p < 0,01. On the 12th day of MI in patients with T2DM and AHF lymphocytes and CD16(+)T&NK-cells counts were lower in comparison with patients without AHF: 1856 (1245; 1975) cells/μL and 2294 (1827; 2625) cells/μL, respectively, p = 0,04; 268 (128; 315) cells/μL and 344 (226 ; 499) cells/ μL, respectively, p = 0,04.Conclusion. In patients with T2DM, the development of AHF is associated with a low number of lymphocytes in the absence of a pronounced monocytic response. In non-diabetic patients, the development of AHF is associated with an increase in CD16(-)monocytes and a lower number of CD16 (+) T&NК-cells.

Aim. To reveal the features of monocyte response in myocardial infarction (MI) in pa­­tients with type 2 diabetes (T2D).Material and methods. The study included 121 patients with MI and T2D as follows: 76 — with target glycated hemoglobin (HbA1c), 45 — with elevated HbA1c values. In addition to the standard examination, all patients underwent a blood test for HbA1c on day 1 of MI, while on days 1, 3, 5, and 12±1, monocyte subpopulations were assessed by flow cytometry.Results. Patients with target HbA1c were older than patients with elevated HbA1c levels. In the group with target HbA1c, the number of CD16(+) monocytes on the 1st day of MI was significantly higher: 61,38 (39,2; 100,08) cells/µl vs 35,7 (28,98; 40,33) cells/µl, p=0,03; on the 3rd day of MI, the number of "intermediate" CD14(+)CD16(+) monocytes was higher: 74,82 (71,78; 83,2) cells/µl vs 25,90 (14,04; 57,12) cells/µl, p=0,03, while the CD16(-) to CD16(+) monocyte ratio on the 3rd day of MI was lower: 8,32 (6 ,87; 10,03) vs 10,81 (8,90; 21,10), p=0,04. At the same time, in the group of patients with target HbA1c values, the level of CD16(+) monocytes on the 3rd day of MI was significantly higher in patients aged <71 years compared with patients ≥71 years: 104,55 (63,64; 149,7) cells/µl vs 55,20 (36,92; 76,59) cells/µl, p=0,03.Conclusion. In patients with T2D and target HbA1c values, compared with patients with elevated HbA1c, the inflammatory response in MI is associated with higher levels of CD16(+) monocytes on days 1 and 3 of MI, which is more typical for people aged <71 years.