EARLY DIAGNOSTIC AND PROGNOSTIC CRITERIA OF ADVERSE COURSE OF ACUTE CORONARY SYNDROME IN TYPE 2 DIABETES
DOI:
https://doi.org/10.11603/2411-1597.2023.3-4.14551Keywords:
acute coronary syndrome, type 2 diabetes mellitus, insulin resistance, risk factorsAbstract
Introduction. Patients with type 2 diabetes have a 2-fold increased risk of developing coronary heart disease, and the risk of death from it is 2–4 times higher than in patients without carbohydrate metabolism disorders.
The aim of the study – to determine the impact of type 2 diabetes and features of the clinical course, expression of changes in laboratory-instrumental parameters, diagnostic paradigm, prognosis and choice of treatment tactics for patients with acute coronary syndrome (STEMI).
The main part. Acute coronary syndrome (STEMI) against the background of type 2 diabetes mellitus develops significantly more often (in 82.8 % of cases) in young and middle-aged men (up to 60 years old), who by gender prevail over female patients in a ratio of 4.8:1. These patients are characterized by the frequent presence of comorbid conditions (hypertension – in 91.4 %, metabolic syndrome – in 82.9 %, chronic kidney disease – in 30.7 %, chronic obstructive pulmonary disease – in 29.3 %, thyroid dysfunction glands – in 22.7 %) and such and such risk factors for coronary heart disease (and their combinations in 89.3 %), such as atherogenic dyslipidemia – in 96.0 %, tobacco smoking – in 34.7 %, use of excessive doses alcohol – in 32.0 %, burdened heredity regarding coronary heart disease – in 29.3 % and type 2 diabetes – in 61.3 % of patients.
Conclusions. It has been established that acute coronary syndrome (STEMI) against the background of type 2 diabetes is 5 times more likely to develop in middle-aged or young men with comorbid pathologies and multiple risk factors for coronary heart disease, is characterized by multivessel and hemodynamically severe damage to the coronary vessels, a large volume of myocardial necrosis, which determines the atypicality and severity of the course of the disease, a high class of heart failure, a significantly higher frequency of life-threatening complications and a high risk of cardiac death.
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