Association of inflammatory markers and poor outcome in diabetic patients presenting with ST segment elevation myocardial infarction

Abstract

Yulia Belenkova,1,2 Viktoria Karetnikova,1,2 Aleksey Diachenko,2 Olga Gruzdeva,1 Olga Blagoveshchenskaya,3 Tatiana Molodtsova,3 Evgenya Uchasova,1 Olga Barbarash1,2 1Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 2State Budgetary Educational Institution of Higher Professional Education Kemerovo State Medical Academy of the Russian Ministry of Health, 3State Budgetary Healthcare Institution Kemerovo Regional Clinical Hospital, Kemerovo, Russian Federation Objective: Carbohydrate metabolism disorders (CMD) significantly impact the development and progression of all forms of ischemic heart disease, and inflammation is regarded as a general pathogenetic link between CMD and ischemic heart disease. Methods: A total of 601 patients with ST segment elevation myocardial infarction (MI) (STEMI), admitted within 24 hours from the onset of symptoms during 1 year, were included in this registry study. The blood levels of inflammation markers were measured at days 10–14 with further follow up at 1 year. Results: The analysis of acute-phase percutaneous coronary intervention impact on the 1-year outcomes showed that endovascular revascularization significantly improved the 1-year prognosis of STEMI patients both with and without CMD. The analysis of inflammation markers showed significantly higher levels of interleukin (IL)-6 and sCD40L in MI patients with diabetes mellitus, and impaired glucose tolerance. Additionally, the patients with impaired glucose tolerance had significantly higher IL-12 levels. In the diabetic MI patients, the odds ratio of a poor 1-year outcome was high for patients with a high Killip classification of acute heart failure upon admission. Conclusion: Persistent inflammation in STEMI patients with CMD undergoing percutaneous coronary intervention might be responsible for vascular complications within 1 year after MI. Comorbid diabetes mellitus or impaired glucose tolerance can amplify the significance of the inflammatory response for the development of adverse 1-year outcomes. Keywords: carbohydrate metabolism disorders, inflammation percutaneous coronary intervention