Algorithm for predicting recurrent myocardial infarction in patients with type 2 diabetes mellitus according to definition of markers of endothelial dysfunction
Keywords:recurrent myocardial infarction, prognosis, asymmetric dimethylarginine, plasminogen activator inhibitor type I , endothelial dysfunction
The combination of cardiac pathology and metabolic disorders, in particular type 2 diabetes, is one of the most common comorbid pathologies and the main cause of death from cardiovascular complications in the early stages of the disease. Despite a wide range of antithrombogenic measures, the prevention of thrombotic complications of acute myocardial infarction remains an urgent problem of cardiology. We examined 73 patients with acute myocardial infarction with concomitant type 2 diabetes mellitus, which were divided into clusters according to severity according to the main parameters of lipid and carbohydrate metabolism using hierarchical analysis. 43 patients (3 persons — from the 1st cluster and 40 from the 2nd cluster) had complications in the form of a repeated myocardial infarction. A system for predicting recurrent myocardial infarction in patients with type 2 diabetes mellitus was developed, which was constructed as an ensemble of classifiers on the basis of the discriminant model and point system of prediction. As predictors for the prediction were used as routine indicators (insulin, cholesterol, final diastolic relaxation, creatinephosphokinase), and specific markers (asymmetric dimethylarginine and plasminogen activator inhibitor type 1). The system of mathematical prediction of recurrent myocardial infarction has a high sensitivity (84.1 %) and specificity (93.1 %) with a total accuracy of 87.7 %, which allows using it in clinical practice to prevent the occurrence of undesirable cardiovascular events.
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