Dynamics of Blood Lipid Profile Indicators in Patients with Acute Myocardial Infarction with Concomitant Type 2 Diabetes Mellitus Depending on the Chosen Treatment Tactics

Abstract

The purpose of the study was to analyze the dynamics of lipid profile in patients with acute myocardial infarction with concomitant type 2 diabetes mellitus for 6 months of follow-up. Materials and methods. 120 patients took part in the study: group 1 – patients with acute myocardial infarction with type 2 diabetes mellitus (n = 70), group 2 – patients with acute myocardial infarction (n = 50). The control group included 20 healthy individuals. Depending on the tactics of treatment, 4 subgroups were formed depending on the tactics of treatment (coronary ventriculography with coronary artery stenting / standard anticoagulant therapy with dual antiplatelet therapy) and the presence or absence of type 2 diabetes mellitus. The diagnosis of "acute myocardial infarction" and "type 2 diabetes mellitus" was established in accordance with current orders of the Ministry of Health of Ukraine. All patients underwent laboratory and instrumental examinations on the first day of acute myocardial infarction and 6 months after it. The study was conducted in strict compliance with basic ethical principles. Statistical processing of the results of this study was performed using the software package StatSoft Inc. USA – "Statistica 6.0". Results and discussion. The average lipid profile on the first day of hospitalization in the examined groups was as follows: total cholesterol in patients of the 1st group was equal to 7.1 ± 1.05 mmol/L; 2nd – 5.45 ± 0.65 mmol/L; control – 2.47 ± 0.42 mmol/L; low-density lipoprotein cholesterol – 4.63 ± 1.07 mmol/L; 3.04 ± 0.65 mmol/L; 0.29 ± 0.32 mmol/L, respectively; low-density lipoprotein cholesterol – 0.64 ± 0.1 mmol/L; 0.47 ± 0.08 mmol/L; 0.24 ± 0.08 mmol/L, respectively; high-density lipoprotein cholesterol – 1.05 ± 0.21 mmol/L; 1.41 ± 0.18 mmol/L; 1.63 ± 0.16 mmol/L, respectively; triglyceride – 3.14 ± 0.48 mmol/L; 2.09 ± 0.57 mmol/L; 1.14 ± 0.39, respectively; atherogenic factor – 6.29 ± 2.92 mmol/L; 2.98 ± 0.86 mmol/L; 0.52 ± 0.21 mmol/L, respectively (p˂0.00001). These indicators were assessed separately for each of the four subgroups. In 6 months after bearing acute myocardial infarction the positive dynamics of indicators of a lipid profile was noted, but the tendency concerning worse indicators in the presence of type 2 diabetes mellitus remained. Patients who underwent coronary artery stenting during treatment compared with patients who received standard anticoagulant therapy with antiplatelet drugs, had a faster positive dynamics of lipid profile. Conclusion. Thus, in patients with comorbid pathology in the form of acute myocardial infarction with type 2 diabetes mellitus, there are high rates of atherogenic lipid fractions, high values of atherogenic factor against the background of low values of antiatherogenic lipid fractions, which has prognostic value in the course of the disease in relation to the progression of atherosclerotic vascular lesions. After coronary ventriculography, a faster positive dynamics of the above indicators was noted, which indicates the superiority of reperfusion methods of treatment over standard drugs