Comparative evaluation of changes in lipid proline in patients with Q-myocardial infarction complicated by acute heart failure with carbohydrate metabolism disorders
| Main Authors: | Victor Syvolap, Nataliya Kapshytar |
|---|---|
| Format: | Article |
| Bahasa: | ukr |
| Terbitan: |
, 2019
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| Subjects: | |
| Online Access: |
https://zenodo.org/record/3755325 |
Daftar Isi:
- The aim was to study the characteristics of lipid metabolism disorders, its pathogenic significance and changes under the influence of lipid-lowering therapy in patients with acute Q-MI, complicated by acute heart failure against different types of hyperglycemia. Materials and methods. There were surveyed 113 patients with acute Q-IM, complicated by acute heart failure against normoglycemia (n=26), hyperglycemia on admission (n=66), type 2 diabetes history (n=21) and 21 practically healthy individuals. After examining patients with hyperglycemia on admission, the following subgroups were distinguished: stress hyperglycemia (n=25), impaired glucose tolerance (IGT) (n=22), new-onset type 2 diabetes (n=19). Patients were determined the lipid profile, insulin level and insulin resistance index (HOMA-IR). For evaluating the effectiveness of the drug lipid-lowering therapy in patients with hyperglycemia on admission, there was conducted subanalysis by the drugs: atorvastitin subgroup – 31 patients (median age 66 (60; 79) years), average daily dose of 21.7±1.1 mg per os, rozuvastatin subgroup - 35 patients (median age 66 (56; 77) years), the average daily dose of 12.8±0.6 mg per os. Results. Compared with the normoglycemia group, the HDL level on the first day was lower by 22 % (p=0.02) in the hyperglycemia on admission group, by 29 % (p=0.005) in patients with IGT and by 33 % (p=0.042) in patients with diabetes mellitus in history, the level of triglycerides – by 15 % (p=0.03) in the IGT subgroup. In the stress hyperglycemia subgroup, the level of total cholesterol on day 12 was higher by 21 % (p=0.027), and triglycerides by 26 % (p=0.043). In patients with hyperglycemia on admission HOMA-IR was 2.11 times higher (p=0.04), in patients with IGT 2.94 times (p=0.02), with new-onset type 2 diabetes 2.91 times higher (p=0.006) compared with normoglycemia. The level of total cholesterol in the atorvastatin subgroup decreased by 21 % (p=0.002), and in the subgroup of rosuvastatin by 11 % (p=0.0005); the level of LDL by 19 % (p=0.0005) and 17 % (p=0.0005), respectively. Conclusions. The lipid profile of patients with type 2 diabetes mellitus in history was characterized by the greatest atherogenic potential. The highest HOMA-IR is registered in the IGT group. The best dynamics of lipid profile was found in patients with normoglycemia. The patients with hyperglycemia on admission, that were receiving atorvastatin, had greater reduction in total and LDL cholesterol levels, than patients, that were receiving rosuvastatin