Neutrophils’ redox regulation and nephropathy development in patients with acute coronary syndrome and Type 2 diabetes mellitus

Abstract

Aim. To study neutrophils’ redox regulation in acute coronary syndrome (ACS) patients with or without Type 2 diabetes mellitus (DM). Material and methods. We examined 100 ACS patients (mean age 63.7±9.4 years): 54 with unstable angina, 46 – with acute myocardial infarction (MI). Type 2 DM was observed in 46 participants. NBT-test for neutrophils, blood levels of malone dialdehyde (MDA) and circulating immune complexes (CIC) were investigated. Results. One-year incidence of MI and death in ACS patients was linked to nephropathy: increased levels of blood creatinine and urea, proteinuria (especially in Type 2 DM), combined with CIC-dependent activation of neutrophils’ redox regulation and activated lipid peroxidation. Maximal mortality was observed in patients with greater duration of DM, and those on pre-hospital insulin therapy. Hyperkaliemia was observed in patients taking aspirin before hospitalization. Conclusion. Poor outcomes in ACS patients are linked to nephropathy (especially in Type 2 DM), associated with CIC-dependent activation of neutrophils’ redox regulation.

Keywords

• acute coronary syndrome
• type 2 diabetes mellitus
• nephropathy
• neutrophils
• active forms of oxygen