Атеросклероз (Jun 2021)
Determination of the probable time of myocardial infarction development in patients with type 2 diabetes mellitus
Abstract
Aim of the study was to create a method for assessing the probabilistic time of development of acute myocardial infarction (AMI) in patients with a confirmed diagnosis of type 2 diabetes mellitus (DM). Material and methods. The work was carried out on the basis of the Regional Vascular Center No. 1 (Novosibirsk). A retrospective analysis of the data of 115 patients diagnosed with AMI in combination with verified type 2 DM who were hospitalized in the period from 2018 to 2019 was performed. In all patients included in the study, clinical and demographic, anamnestic, physical, functional, and laboratory data were assessed in accordance with the federal standard for the diagnosis and treatment of this pathology. The nature and duration of the course, drug therapy for diabetes mellitus were assessed according to medical documents and databases. Further, a regression model was built for assessing the probabilistic time of development of AMI in patients with type 2 DM. Results. The author’s model for assessing the probabilistic time of development of acute myocardial infarction in patients with type 2 DM included eight indicators that significantly correlated with the dependent variable and weakly correlated with each other: patient gender, chronic kidney disease with a decrease in glomerular filtration rate to 60 ml/min/1.73 m2, diabetic retinopathy, verified peripheral polyneuropathy, cigarette smoking 1 pack or more, the number of hemodynamically significant coronary artery stenoses according to the results of selective coronary angiography, the use of short-acting insulin as part of hypoglycemic therapy, the use of long-acting insulin as part of hypoglycemic therapy. Conclusion. The study demonstrates the high predictive ability of the author’s approach for determining the individual predicted time for the development of AMI in a patient with type 2 DM. The introduction of the developed method into real clinical practice will make it possible to personally manage type 2 DM patients and to reduce the individual risk of such a formidable cardiovascular complication as myocardial infarction.
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