ASSESSMENT OF RE-HOSPITALIZATION PROBABILITY IN PATIENTS WITH POST-INFARCTION CARDIOSCLEROSIS AND COMORBID PATHOLOGY
Authors: Koteliukh M. Yu. 
Published: April 2021

Abstract. The aim of our research was to examine the risk factors for re-hospitalization in patients with acute myocardial infarction with concomitant diabetes mellitus (DM) 2 type or obesity.

Materials and methods. The research involved examination of 262 patients with post-infarction cardiosclerosis in combination with type 2 DM or obesity. They were divided into groups: Group 1 included 96 patients who were not hospitalized for 12 months; comparison group 2 consisted of 166 patients who were hospitalized to an in-patient department. The average age of the first group was 65.13±1.43 years, the comparison group – 63.47 ± 1.28 years. Patients were divided into 3 groups to assess the value of CTRP 3 in chronic heart failure (CHF): Group 1 included 80 patients with post-infarction cardiosclerosis without type 2 DM or obesity, Group 2 consisted of 74 patients with post-infarction cardiosclerosis with type 2 DM, Group 3 comprised 60 patients with post-infarction cardiosclerosis and obesity. The research included patients who were treated at the State Institution “L.T. Malaya National Institute of Therapy of the National Academy of Medical Sciences of Ukraine” and in the first cardiology department of Kharkiv Clinical Hospital or Rail Transport No.1 of the “Healthcare Center” branch of the Joint Stock Company “Ukrainian Railways”. Determination of cartonectin and adropin levels was performed by enzyme-linked immunosorbent assays using the commercial test system Human CTRP 3 (Aviscera Bioscience Inc, Santa Clara, USA) and Human Adropin (Elabscience Biotechnology, USA). Statistical processing of the obtained data was performed using the statistical software package “IBM SPPS Statistics 27.0” and “GraphPad Prism software version 9.0.2”. For all types of analysis, the differences were considered statistically significant at p <0.05. One-factor analysis of variance was used to characterize the influence of factors on the indicators. The method of discriminant analysis was used to assess the occurrence of re-hospitalization.

Results. The research revealed a decrease in CTRP 3 in the progression of CHF in patients with post-infarction cardiosclerosis in the presence and absence of concomitant type 2 DM or obesity. The effect of diastolic blood pressure, CHF, glucose, the presence of type 2 DM and obesity on the content of CTRP 3 and adropin was determined. Cartonectin has been shown to be a risk factor for re-hospitalization. An assessment scale for the likelihood of re-hospitalization in patients with post-infarction cardiosclerosis and concomitant type 2 DM or obesity has been developed. We analyzed clinical cases of re-hospitalization among patients with post-infarction cardiosclerosis in the presence of concomitant pathology.

Conclusions: CTRP 3 has been shown to be associated with the progression of CHF in patients with post-infarction cardiosclerosis and comorbid pathology. The results indicate the effect of hypertension, CHF, type 2 DM and obesity on the content of cartonectin and adropin. As a result, it has been shown that cartonectin is a factor influencing the occurrence of re-hospitalization in patients with post-infarction cardiosclerosis in the presence of syntropic pathology. The proposed method allows to assess the likelihood of re-hospitalization in patients with post-infarction cardiosclerosis with comorbid pathology.