DYNAMICS OF GALECTIN-3 LEVELS IN PATIENTS WITH ACUTE CORONARY SYNDROMES AND 2 TYPE DIABETES MELLITUS UNDER THE INFLUENCE OF EMPAGLIFLOZIN AND TRIMETAZIDINE
Authors: Федоров Сергій Валерійович , Bondareva O. O. 
Published: October 2022

It is known that cardiovascular diseases (CVD) will continue to occupy a prominent place in the structure of morbidity, mortality and disability of the world population. Patients with diabetes (DM) are several times more likely to develop adverse cardiovascular events. In recent years, markers of inflammation, which are involved in the progression of atherosclerosis, have been studied. One of them is galectin-3, which is involved in cell differentiation, fibrosis and immune inflammation. Data on changes in the activity of galectin-3 concentration in patients with ACS are scarce and contradictory.

The purpose is to study the dynamics of galectin-3 content in the blood of patients with acute coronary syndromes (ACS) and concomitant type 2 diabetes in the course of treatment using empagliflozin and trimetazidine.

Material and methods. At the first stage, 124 patients with ACS were examined; the control group consisted of 30 practically healthy people. The second stage of the study included 93 patients with ACS and diabetes, who, depending on the treatment strategy, were divided into 3 subgroups: 29 patients who were prescribed therapy in accordance with the guidelines; 30 patients who were additionally prescribed empagliflozin at a dose of 10 mg per day; 34 patients were prescribed a combination of empagliflozin and trimetazidine at a dose of 35 mg twice a day in addition to optimal drug therapy. All patients were examined upon admission before starting the course of treatment. Repeated examinations were carried out on the 28th day and after 3 months. Galectin-3 content was determined by enzyme- linked immunosorbent assay (ELISA). General laboratory tests were carried out, as well as determination of blood levels of brain natriuretic peptide (NT - proBNP), highly sensitive C-reactive protein (hs CRP), glycosylated hemoglobin. The severity of coronary artery damage was calculated according to the Gensini scale. Statistical processing received data were collected using the standard package of the "Statistics 12" program. The data were considered reliable at p <0.05.

Research results. The average age of the examined patients was (63.4 ± 5.21) years. The average values of galectin-3 levels in the blood of patients with ACS without type 2 diabetes were: (28.23 ± 3.17) ng /ml, and with concomitant DM – (35.67 ± 2.98) ng /ml  (p <0.01), which was 3.18 and 4.01 times higher indicators of control groups : (8.89 ± 3.41) ng /ml, respectively (p <0.001).

By the multivariate method regressive linear modeling noted dependence between levels of galectin-3 in patients with ACS with type DM and the number of leukocytes, levels hsCRP, NT- proBNP, creatinine, glucose, glycosylated hemoglobin and severity of coronary artery damage due to the Gensini scale.

At the end of study, on the 28th day, a significant decrease in the content of galectin-3 in the blood was observed only in the group of patients who were additionally prescribed a combination of empagliflozin and trimetazidine - by 22.13% of the initial values. At the end of observation (3rd month) in all groups of examined patients, the average values of the specified indicator decreased to the same extent, however, they did not return to normal values.

Conclusions:

Concomitant type 2 diabetes significantly affects the increase of galectin-3 levels in the blood of patients with acute coronary syndrome.

The additional appointment of trimetazidine leads to a faster decrease in the levels of galectin-3 in the blood of patients.