The role of plasminogen activator ingibitor type 1 in the development of endothelial disfunction in patients with acute myocardial infarction and type 2 diabetes mellitus
Keywords:acute myocardial infarction, type 2 diabetes mellitus, plasminogen activator ingibitor type 1, NO synthase, endothelial dysfunction, carbohydrate and lipid metabolism parameters, coagulation parameters
Acute myocardial infarction continues to occupy one of the leading places among the causes of mortality. Some indicators of endothelial dysfunction are also associated with a high risk of cardiovascular complications, which play a key role in the pathogenesis of cardiovascular complications, which makes it relevant to study the relationship between endothelial dysfunction markers and the development and progression of atherosclerotic vascular lesions. Dysfunction of the endothelial vasodilator system is accompanied by a decrease in the level of nitric oxide (NO), which is a characteristic feature of patients who are at risk of coronary artery disease, so coronary vasodilator dysfunction may involve prolonged progression of atherosclerosis and the frequency of cardiovascular events. The high risk of vascular accidents is an incentive to study the pathogenetic mechanisms of thrombotic formation in type 2 diabetes. Plasminogen activator inhibitor type 1, which is a member of the superfamily of serine protease inhibitors and the main inhibitor of fibrinolysis in the plasminogen activator system, plays a key role in the pathogenesis of arterial and venous thrombosis and, therefore, contributes to the occurrence of thrombotic events. The combination of acute myocardial infarction with type 2 diabetes mellitus is characterized by a significant increase in the content of the plasminogen activator inhibitor type 1 in serum compared with those without diabetes. As a result of the study, a close direct correlation between the increase of lipid, carbohydrate metabolism, hemostasis parameters proportional to the high content of the plasminogen activator inhibitor type 1 in serum of patients with acute myocardial infarction with concomitant type 2 diabetes mellitus was proved. The inverse correlation between the level of type 1 plasminogen activator inhibitor and the reduced content of nitric oxide synthase, which increases endothelial dysfunction and atherothrombosis in patients with acute myocardial infarction with concomitant type 2 diabetes mellitus, is proved.
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