5. Zak MYu. [Clinico-functional and morphological aspects of peptic ulcer of the duodenum and chronic gastritis in hypertensive patients and their treatment]. [dissertation]. "Gastroenterologiya", Dnipropetrovsk. 2005;23. Ukrainian. 6. Krivorchuk IG, Mishalov VG. [Developmental risk groups and prevention methods for acute arterial mesenterial ischemia]. Ukrayinskyi medichnyi chasopis. 2014;5(103):121-2. Russian. 7. Lazebnik LB, Miheeva OM, Komissarenko IA et al. [Features of the combined course of arterial hypertension and peptic ulcer in elderly patients]. Eksperimentalnaya i klinicheskaya gastroenterologiya. 2004;6:1-11. Russian. 8. Parahonskii AP. [Pathogenetic bases of development of gerontium polymorbidity]. Uspehi sovremennogo estestvoznaniya. 2009;7:81-82. Russian. 9. Surmilo MM, inventor; ZMAPO, assignee [Patent 31171 Ukraine, IPC A 61 to 35/12, A 61 to 36/00. Method of treatment of patients with chronic diseases of the digestive system with microcirculatory disorders in a hospital setting]. Ukraine, U200714157, 17.12.2007, 2008.25.03. Ukrainian. 10. Smirnova LE. [Systemic disorders and the possibility of their outpatient correction in the combined course of peptic ulcer and arterial hypertension]. [dissertation]. Moskva. 2006;38. Russian. 11. Stepanov YuM. [Digestive diseases and gastroenterological help: achievements, problems and ways of their solution]. Zdorovia Ukrainy. 2014;3:10-11. Ukrainian. 12. Surmilo MM. [Cardiovascular continuum and peptic ulcer disease]. Ukr. terapevt. 2011;3:106-13. Ukrainian. 13. Surmilo NN. [Diagnosis and antihomotoxic therapy of microcirculatory disorders in the case of chronic diseases of the digestive system]. Biologicheskaya terapiya. 200;1:16-18. Ukrainian. 14. Surmilo NN. [Treatment of violations of central hemodynamics in patients with duodenal ulcer in the period of medical rehabilitation]. Actual questions of medical rehabilitation, health resorts and physiotherapy for adults and children.

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It is known that cardiovascular diseases (CVD) will continue to occupy a prominent place in the structure of morbidity, mortality and disability of the world population. Patients with diabetes (DM) are several times more likely to develop adverse cardiovascular events. In recent years, markers of inflammation, which are involved in the progression of atherosclerosis, have been studied. One of them is galectin-3, which is involved in cell differentiation, fibrosis and immune inflammation. Data on changes in the activity of galectin-3 concentration in patients with ACS are scarce and contradictory. The purpose is to study the dynamics of galectin-3 content in the blood of patients with acute coronary syndromes (ACS) and concomitant type 2 diabetes in the course of treatment using empagliflozin and trimetazidine. Material and methods. At the first stage, 124 patients with ACS were examined; the control group consisted of 30 practically healthy people. The second stage of the study included 93 patients with ACS and diabetes, who, depending on the treatment strategy, were divided into 3 subgroups: 29 patients who were prescribed therapy in accordance with the guidelines; 30 patients who were additionally prescribed empagliflozin at a dose of 10 mg per day; 34 patients were prescribed a combination of empagliflozin and trimetazidine at a dose of 35 mg twice a day in addition to optimal drug therapy. All patients were examined upon admission before starting the course of treatment. Repeated examinations were carried out on the 28th day and after 3 months. Galectin-3 content was determined by enzyme- linked immunosorbent assay (ELISA). General laboratory tests were carried out, as well as determination of blood levels of brain natriuretic peptide (NT - proBNP), highly sensitive C-reactive protein (hs CRP), glycosylated hemoglobin. The severity of coronary artery damage was calculated according to the Gensini scale. Statistical processing received data were collected using the standard package of the "Statistics 12" program. The data were considered reliable at p <0.05. Research results. The average age of the examined patients was (63.4 ± 5.21) years. The average values of galectin-3 levels in the blood of patients with ACS without type 2 diabetes were: (28.23 ± 3.17) ng /ml, and with concomitant DM – (35.67 ± 2.98) ng /ml  (p <0.01), which was 3.18 and 4.01 times higher indicators of control groups : (8.89 ± 3.41) ng /ml, respectively (p <0.001). By the multivariate method regressive linear modeling noted dependence between levels of galectin-3 in patients with ACS with type DM and the number of leukocytes, levels hsCRP, NT- proBNP, creatinine, glucose, glycosylated hemoglobin and severity of coronary artery damage due to the Gensini scale. At the end of study, on the 28th day, a significant decrease in the content of galectin-3 in the blood was observed only in the group of patients who were additionally prescribed a combination of empagliflozin and trimetazidine - by 22.13% of the initial values. At the end of observation (3rd month) in all groups of examined patients, the average values of the specified indicator decreased to the same extent, however, they did not return to normal values. Conclusions: Concomitant type 2 diabetes significantly affects the increase of galectin-3 levels in the blood of patients with acute coronary syndrome. The additional appointment of trimetazidine leads to a faster decrease in the levels of galectin-3 in the blood of patients.

Cardiovascular diseases cause approximately one-third of all deaths in the world, of which 7.5 million deaths are estimated to be due to ischemic heart disease (IHD). Acute coronary syndromes (ACS) and sudden death cause most IHD-related deaths, which represent 1.8 million deaths per year. Established, that patients with diabetes mellitus (DM) are more likely to experience of ACS and heart failure and are at greater risk for dying after an acute cardiac event, than patients without diabetes. The purpose of this study is evaluation of leukocyte and its populations count, leukocytes indices and plasma level of high sensitive C-reactive protein (hsCPR) in patients hospitalized due to ACS with or without of 2 type DM. Material and Methods. We observed of 124 patients with ACS which were randomized into two groups: 1st group – 93 patients with ACS and DM; 2nd group – 31 patients with ACS without 2 type DM. 30 apparently healthy persons were included into control group. We studied of leukocytes count and their subpopulations in blood; calculated of their subpopulation indices: neutrophils to lymphocytes ratio (NLR), neutrophils to monocytes ratio (NMR), neutrophils to lymphocytes+monocytes ratio (N/LMR), lymphocytes to monocytes ratio (NMR) at admission. The plasma levels of hs-CRP were detected by ELISA method. Results of study. The significant increase of white blood cells count and neutrophils count in patients with ACS at admission was detected in our study, especially in cases with DM. On the contrary, the counts of lymphocytes were decreased in patients with ACS and ACS with 2 type DM, versus data in control group. In patient with ACS the increased parameter of NMR was observed (p<0.001). Similarly, the following indices were higher, compared with control group parameters: NLR – for 3.32 times (in patients with ACS and DM) and for 2.43 times (in patients with ACS and without DM) (p<0.001); N/LMR – for 2.98 times (in patients with ACS and DM) and for 2.14 times (in patients with ACS and without DM) (p<0.001). On the contrary, LMR was decreased in both groups of patients with ACS – for 1.4 times and 1.36 times, respectively (p<0.05). The increased plasma levels of hs-CRP were detected in patients with ACS, more significant – in case of 2 type DM (fig. 1): for 2.1 times and for 2.59 times, respectively (p<0.001). Conclusion. ACS is characterized of raised white blood cells and neutrophils count and low lymphocyte count, especially in cases of association with 2 type Diabetes Mellitus. Low-grade inflammation in patients with ACS and DM caused of increased levels of hs-CRP and some leukocyte ratios: NMR, N/LMR, NLR.

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