THE ROLE OF INFLAMMATION FOR THE WORSE OUTCOMES IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION UNDERWENT TRANSCUTANEOUS CORONARY INTERVENTION, COMORBID WITH IMPAIRED GLUCOSE TOLERANCE

Aim. To evaluate the significance of non-specific inflammatory markers for estimation of the risk for poor annual prognosis in patients after myocardial infarction with ST segment elevation (STEMI) and diabetes mellitus (DM) 2 type or impaired glucose tolerance (IGT), underwent transcutaneous coronary intervention (PCI).

Material and methods. Totally 601 STEMI patient included into registry study with mean age 62,9 (32,0-94,0). On 8-14th day all patients without any known glucose intolerance or postprandial glucose not higher than 11,1 mMpL underwent glucose tolerance test. On 10-14th day after MI blood samples were taken to measure inflammatory markers (fibrinogen, interleukines -6,—8,—12, tumor necrosis factor alpha TNF-a, high-sensitive C-reactive protein, sCD40L) with further control of postinfarction recovery during 1 year. The cytokine concentration was measured with competitive immunoferment assay, hs-C-rp was measured with solid-phase immunoferment analysis. With the data of angiography taken, primary PCI was done for 373 (62,06%) of patients, for 228 (37,94%) non-invasive treatment strategy was preferred.

Results. Patients with STEMI were divided into 3 subgroups: without IGT (n=429; 71,38%), with IGT (n=32; 5,33%), with DM (n=140; 23,29%), of those in 16 (11,42%) the diagnosis was first time. It was found out that PCI significantly improves prognosis of STEMI with and without IGT. The analysis of inflammatory markers in MI with DM or IGT comparing to those without IGT at the end of hospitalization showed significantly higher levels of IL-6 and sCD40L, and in patients with ICGT also there was significantly increased IL-12 comparing to the patients without IGT.

Conclusion. For the patients with STEMI and IGT, underwent PCI, processes of inflammation are responsible for the risk of negative vascular events during one year. Comorbidity of DM and IGT increases prognostic significance of inflammation for the negative outcome.

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