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The Lipid and Carbohydrate Profile in Patients with Postinfarction Cardiosclerosis, Type 2 DM and Obesity in 6 Months and 1 Year after MI

Contributed by: Kharkov National Medical University

The aim of the study was to investigate the carbohydrate and lipid metabolism in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity in 6 months and 1 year after myocardial revascularization.
58 patients were examined who took thrombolytic therapy and 32 patients who underwent percutaneous coronary intervention. The diagnosis of myocardial infarction was determined by criteria ESC / ACCF / AHA / WHF (2012). Diagnosis of diabetes was conducted in accordance with the criteria of the World Federation of Diabetes (International Diabetes Federation, IDF, 2013). To characterise obesity defined by body mass index, which is calculated by the formula: weight (kg)/height (m2). The glucose level was determined by glucoseoxidant method, insulin – by ELISA and lipid profile - according to standard biochemical methods.

Results: With the background of percutaneous coronary intervention and thrombolytic therapy leads to improvement in carbohydrate and lipid metabolism. The comparison of two methods of revascularization at 6 months showed no preference to any of them in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity.

Before treatment in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity found significantly higher values of such indicators as insulin (at 9.58 % and 15.62 % respectively), glucose (at 19.81 % and 24.94 % respectively), total cholesterol (7.85 % to 9.81 % and respectively), triglycerides (by 7.81 % and 8.46 %, respectively), low density lipoproteins (by 6.71 % and 8.26 %, respectively), very low density lipoproteins (at 24.38 % and 24.95 % respectively) and lower values of high density lipoproteins (47.9 % and 46.16 %, respectively) compared with the value of these parameters in patients at 1 year after percutaneous coronary intervention and thrombolytic therapy, respectively (p<0.05). That is, after 1 year of thrombolytic therapy and percutaneous coronary intervention had the same effect on the studied parameters in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity, as well as 6 months.

And finally, most importantly, the results indicate that delayed percutaneous coronary intervention after successful thrombolytic therapy – pharmacoinvasive strategy – not inferior to its clinical efficacy of primary percutaneous coronary intervention.

Conclusion: Established that in patients with postinfarction cardiosclerosis, type 2 diabetes and obesity saw a positive effect defined in carbohydrate and lipid metabolism by reducing level of blood glucose, insulin, total cholesterol, low and very low density lipoproteins, triglycerides and increasing of high density lipoproteins cholesterol in 6 months and 1 year after reperfusion therapy. As in 6 months and 1 year after revascularization significant differences in carbohydrate and lipid metabolism in the examined patients, depending on the type of reperfusion therapy have not been established, thus indicating that a comparative analysis of different modes of myocardial revascularization did not show any advantages of them.

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    Kharkov National Medical University
    Nauki avenue,4
    61022 Kharkov
    Ukraine
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  • Ukraine

Keywords

postinfarction cardiosclerosis, type 2 diabetes, obesity, revascularization, lipoproteins
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