PROGNOSTIC VALUE ENDOTHELIAL MONOCYTE ACTIVATING POLYPEPTIDE – ІІ IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION IN COMBINATION WITH 2 DIABETES MELLITUS AS A MARKER OF RECURRENT CARDIOVASCULAR EVENTS WITHIN 6 MONTHS OF OBSERVATION
Authors: Feldman D. A. 
Published: December 2021

The aim of the research. Analyze the prognostic value of endothelial monocyte activating polypeptide – ІІ as a marker of recurrent cardiovascular events in patients with acute myocardial infarction with type 2 diabetes mellitus within 6 months of follow-up after a coronary event.

Materials and methods. The research involved 120 patients. All subjects were included in 2 groups: group 1 - patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM), group 2 - patients with AMI (n = 50). The control group included 20 healthy individuals.

Examination of patients was performed on the basis of the cardiology department for patients with acute myocardial infarction KNP "City Clinical Hospital №27" HMR and the 1st cardiology department of Kharkiv Clinical Hospital by rail №1 branch "Health Center" of the Joint Stock Company "Ukrainian Railways" .

The participants of the research on the first day of AMI were determined the level of human endothelial monocyte activating polypeptide – ІІ (EMAP-II) in the serum using enzyme-linked immunosorbent assay using a commercial test system manufactured by Bioassay Technology Laboratory (China) in accordance with the enclosed instructions on enzyme-linked immunosorbent assay "Labline-90" (Austria).

General clinical and instrumental examinations were performed on patients who were part of the 1st, 2nd groups and control groups.

People who participated in the research were informed about the purpose, objectives, materials and methods of the research by signing an informed consent to participate in it. During the research, measures were taken to ensure the anonymity of each of its participants.

Statistical processing of survey results was performed using software package StatSoft Inc USA - "Statistica 6.0".

Research results. The average level of EMAP-II in patients who were in the 1st group was 4.54 ± 0.331 ng / ml, the 2nd - 2.74 ± 0.21 ng / ml, in the control group - 1.1 ± 0.037 ng / ml (p <0.05).

A recurrent cardiovascular event in the form of recurrent AMI occurred in 19 patients (27.14%) who were part of the 1st group and in 7 patients (14%) who belonged to the 2nd group.

The research found that the value of EMAR-II> 5.42 μmol / l in patients with AMI in combination with type 2 diabetes and> 2.64 μmol / l in patients with AMI without concomitant type 2 DM is a predictor recurrence of AMI within 6 months of follow-up after a coronary event.

Based on the results of the research, a multifactor logistic regression model for the prognosis of recurrent AMI in patients with AMI in combination with type 2 DM was developed using EMAR-II for 6 months of follow-up after a coronary event.

Conclusions. Thus, the level of endothelial monocyte activating polypeptide – ІІ in patients with acute myocardial infarction correlates with the presence of comorbid pathology in the form of type 2 diabetes mellitus, having the highest level in its presence, reflecting endothelial dysfunction that pathogenetically combines these diseases.

According to the above, to date, the question remains about the prognostic value of endothelial monocyte activating polypeptide – ІІ in acute myocardial infarction in patients with concomitant type 2 diabetes mellitus during the 6-month follow-up period after a cardiovascular event.

It is advisable to further research the rate of endothelial dysfunction - endothelial monocyte activating polypeptide – ІІ as a predictor of recurrent cardiovascular events in patients with acute myocardial infarction in combination with concomitant type 2 diabetes mellitus within 6 months after the coronary event.