EFFECTIVENESS OF DYSLIPIDEMIA AND PRO-OXIDANT-ANTIOXIDANT BALANCE CORRECTION IN PATIENTS WITH ACUTE CORONARY SYNDROME ON THE BACKGROUND OF TYPE 2 DIABETES WITH SGLT2 INHIBITOR – DAPAGLIFLOZIN

Abstract

Introduction. The total risk of myocardial infarction development in the next 8 years in people with obesity and diabetes mellitus 2 is 30 % and their mortality is twice as high as in patients without metabolic disorders. An unfavo­rable prognosis in patients with ACS on the background of diabetes mellitus 2 is associated with a severe, complicated course of the disease, limitation of invasive coronary interventions, etc., which determines the tactics of active study of the role of triggers and risk factors in the pathogenesis of this comorbid pathology and the development of ways to correct these pathological processes.

The aim of the study – to investigate the efficiency of correcting lipid profile disorders and the balance of the pro-oxidant-antioxidant system in patients with acute coronary syndrome combined with type 2 diabetes and a high risk of developing reperfusion complications by using the SGLT2 inhibitor dapagliflozin.

Research Methods. The work is based on the analysis of a comprehensive examination and surgical (percutaneous coronary intervention) treatment of 56 patients with acute coronary syndrome in combination with type 2 diabetes. Lipidogram indicators and the activity of components of the pro-oxidant-antioxidant system were determined using spectrophotometric methods, the optical density was measured on a spectrophotometer “Biomat 5” (Great Britain).

Results and Discussion. In order to correct the lipid profile and prooxidant-antioxidant balance in the pre- and postoperative periods, dapagliflozin was prescribed at a dose of 10 mg/day, which made it possible to compensate hyperglycemia and stabilize the activity of the prooxidant-antioxidant system at the time of surgery, prevent the development of reperfusion complications after PCI, and stabilize the clinical condition of comorbid patients in the postoperative period due to decrease the rhythm frequency and conduction disturbances by 41.2 %, manifestations of acute heart failure by 55.9 %. In particular, in the peri- and postoperative periods, the activity of free radical oxidation significantly decreased, which was evidenced by a 1.3-fold decrease (р<0.05) in the content of active products of thiobarbituric acid in blood serum and the simultaneous restoration of the functioning of the enzyme antioxidant systems of the body, a 1.5-fold decrease (p<0.05) in the degree of blocking of superoxide dismutase activity and increase in catalase and ceruloplasmin activity.

Conclusion. The use of dapagliflozin in the pre- and postoperative periods in patients with ACS in combination with type 2 diabetes with a high operational risk contributes to the normalization of lipid metabolism and a significant reduction in the activity of free radical oxidation with the restoration of the functioning of the enzyme antioxidant systems of the body, which makes it possible to reduce the frequency of rhythm and conduction disturbances by 41.2 % and manifestations of acute heart failure by 55.9 %.