COMPREHENSIVE ASSESSMENT OF ENDOTHELIUM-DEPENDENT MEDIATORS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND DIABETES MELLITUS TYPE 2
Keywords:acute myocardial infarction, diabetes mellitus type 2, NOS, PAI-1, sCD40L.
The aim of study is to evaluate the levels of endothelium-dependent mediators: endothelial nitric-oxide synthase (NOS), plasminogen activator inhibitor-1 (PAI-1) and circulating soluble CD40 ligand (sCD40L) in patients with acute myocardial infarction (AMI) and concomitant type 2 diabetes mellitus (DM). The study included 255 patients with AMI, who were divided into two groups depending on the presence of concomitant type 2 DM: 1 group — 143 patients with concomitant type 2 DM; 2 group — 112 patients without concomitant disturbances of carbohydrate metabolism. Studied endothelial-dependent indicators were investigated using enzyme-linked immunosorbent assay. Statistical data were processed using the Mann–Whitney U-test, quantitative variables were described by the following parameters: median (Me), 25th and 75th percentiles (Q1; Q3). Analyzing the studied indicators on admission of patients to the hospital, a statistically significant decrease in NOS levels (p < 0,01), as well as an increase in PAI-1 (p < 0,01) and sCD40L (p < 0,01) in the cohort of patients with AMI and concomitant type 2 DM compared with patients without disturbances of carbohydrate metabolism. This indicates a more significant violation of endothelium-dependent vasodilation, thrombin fibrinolysis and activation of intravascular inflammation caused by comorbidity. Over the next 10 days, an increase in NOS levels, a decrease in PAI-1 and sCD40L levels were observed in patients of both groups, indicating a gradual improvement of the endothelial function. However, in patients with AMI and concomitant type 2 DM, the levels of the studied endothelium-dependent mediators continued to differ statistically even on the 10th day after acute occlusion of the coronary artery. In our opinion, this tendency is caused by the negative impact of metabolic
disorders associated with type 2 DM on the endothelium of the coronary arteries in patients with insulin resistance and, apparently, may increase the risk of complications of AMI.
Berns SA, Shmidt EA, Yuhno ES, et al. Kardiologiya 2015;4: 14-18. https://doi.org/10.18087/cardio
Sena CM, Pereira AM, Seica R. Biochim Biophys Acta 2013;1832: 2216-2231. https://doi.org/10.1016/j.badis.2013.08.006.
Ketete M, Cherqaoui R, Maqbool A, et al. J Biomed Sci Engineering 2013;6: 593-597. https://doi.org/10.4236/jbise.2013. 66075.
Fleming I, Busse R. Cardiovasc Res 1999;43(3): 532-541. https://doi.org/10.1016/s0008-63(99)00094-2.
Li J-L, Yang Z, Wu S, et al. J Int Med Res 2012;40(2): 687-693. https://doi.org/10.1177/147323001204000232.
Sobel B, Taatjes D, Schneider D. Arterioscler Thromb Vasc Biol 2003;23(11): 1979-1989. https://doi.org/10.1161/01.atv.0000091250.53231.4d.
Lopez-Alemany R, Redondo J, Nagamine Y, et al. Eur J Biochem 2003;270(5): 814-821. https://doi.org/10.1046/j.1432-1033.2003.03453.x.
Juhan-Vague I, Alessi M, Vague P. Diabetologia 1991;34(7): 457-462. https://doi.org/10.1007/bf00403280.
Aloui C, Priqent A, Sut C. Int J Mol Sci 2014;15(12): 22342-22364. https://doi.org/10.3390/ijms151222342.
Zaikina TS. Visnyk problem biolohii i medytsyny 2015;3(2): 118-122. https://doi.org/10.29254.
Ibanez B, James S, et al. Eur Heart J 2017: 1–66. https://doi.org/10.1093/eurheartj/ehx393
American Diabetes Association. Diabetes Care 2000;43(1): 14-31. https://doi.org/10.2337/dc20-S002.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310(20): 2191-2194. https://doi.org/10.1001/jama.2013.281053.
Huang Y, Qiu J, Zhang D, et al. Biofactors 2011;37(2): 88-94. https://doi.org/10.1002/biof.145.
Seijkens T, Kusters P, Engel D, et al. Diab Vasc Dis Res 2013;10(2): 115-122. https://doi.org/10.1177/1479164112455817.
Gruzdeva O, Uchasova E, Dyleva Y, et al. Diab Metab Syndr Obes 2013;6: 293-301. https://doi.org/10.2147/DMSO.S46627
Jung R, Motazedian P, Ramirez F, et al. Thromb J 2018; 16: 12. https://doi.org/10.1186/s12959-018-0166-4
Minukhina DV, Babadjan VD, Minukhin DV, et al. Wiad Lek 2020;73(1): 123-127. https://doi.org/10.36740/WLek202001124.