Cardiac biomarkers and left ventricular systolic function in acute myocardial infarction with ST- segment elevation in diabetes mellitus type 2 patients
Department of Cardiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases,
Clinical Center University of Sarajevo
, Sarajevo
, Bosnia and Herzegovina
Department of Cardiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases,
Clinical Center University of Sarajevo
, Sarajevo
, Bosnia and Herzegovina
Department of Cardiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases,
Clinical Center University of Sarajevo
, Sarajevo
, Bosnia and Herzegovina
Department of Rheumatology,
Clinic for Heart, Blood Vessels and Rheumatic Diseases, Clinical Center University of Sarajevo
, Sarajevo
, Bosnia and Herzegovina
Aim To determine a status of systolic function in patients with diabetes mellitus (DM) type 2 with ST-segment elevation acute myocardial infarction (STEMI), to determine values of cardiac biomarkers in patients with DM type 2 with STEMI and correlate the parameters with ejection fraction of left ventricle (EFLV). Methods A total of 80 patients were divided into two groups, the study group (group I) consisting of 40 patients admitted with the diagnosis of DM type 2 and STEMI, and a control group (group II) with 40 patients with STEMI without diagnosed DM type 2. Cardiac biomarkers-creatine kinase MB fraction (CKMB), and troponin I were monitored. The EFLV was evaluated echocardiographically (using Simpson method) five days after primary percutaneous coronary intervention (pPCI). Results In the group I the EFLV five days after pPCI was significantly correlated with troponin values (with a minimum r =-0.47; p=0.002, a maximum r =-0.339; p = 0.032, as well as with an average value of r =-0.389; p=0.013), and with an average CK value (r =-0.319; p=0.045). In the group II there was a significant negative correlation of EFLV with the maximum value of troponin (r =-0.309; p=0.05). Conclusion Troponin values have an effect on the EFLV after STEMI, and thus on the left ventricular status, as well as on the pharmacological modality itself.
Beckman J, Creager M, Libby P. Diabetes and Atherosclerosis 2002:2570–81.
2
Mythili S, Malathi N. Diagnostic markers of acute myocardial infarction. Biomed Rep 2015:743–8.
3
Shah R, Chen-Tournoux A, Picard M, Januzzi J. Association between troponin T and impaired left ventricular relaxation in patients with acute decompensated heart failure with preserved systolic function. Eur J Echocardiogr 2009:765–8.
4
Khan M, Islam M, Aditya G, Islam M, Bhuiyan A, Saha B, et al. Correlation of troponin-IlLevel with left ventricular ejection fraction and in-hospital outcomes after first attack of non-ST segment elevation myocardial infarction. Mymensingh Med J 2017:721–31.
5
Schmidt A. Diabetes mellitus and cardiovascular disease emerging therapeutic approaches. Arterioscler Thromb Vasc Biol 2019:558–68.
6
Lin T, Wu C, Yang Y, Lin L, Lin J, Chen P, et al. Anti-hyperglycemic agents and new-onset acute myocardial infarction in diabetic patients with end-stage renal disease undergoing dialysis. PLoS One 2016:160436.
7
Monteiro S, Monteiro P, Gonçalves F, Freitas M, Providência L. Hyperglycaemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics. Eur J Prev Cardiol 2010:155–9.
8
Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T, et al. Hyperglycemia and acute coronary syndrome. Anesthesiology 2008:14–24.
9
Cubbon R, Rajwani A, Abbas A, Gale C, Grant P, Wheatcroft S. EMMACE-2 (Evaluation of Methods Management of Acute Coronary Events) Study Group. Hyperglycaemia, in relation to sex, and mortality after acute coronary syndrome. Eur J Prev Cardiol 2007:666–71.
10
Lipsic E, Van Der Horst I, Voors A, Van Der Meer P, Nijsten M, Van Gilst W, et al. Hemoglobin levels and 30-day mortality in patients after myocardial infarction. Int J Cardiol 2005:289–92.
11
Feng Q, Zhao Y, Li Y. Effect of haemoglobin concentration on the clinical outcomes in patients with acute myocardial infarction and the factors related to haemoglobin. BMC Res Notes 2011:142.
12
Malmberg K, Yusuf S, Gerstein H. Impact of diabetes on long-term prognosis in patients with unstable angina and non-Q-wave myocardial infarction: results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) Registry. Circulation 2000:1014–9.
13
Haffner S, Letho S, Romnema T, Pyörälä K. Laakso M. Morality from coronary heart disease inpatients with typ 2 diabetes and in nondiabetes patients with and without prior myocardial infaction. N Engl J Med 1998:229–224.
14
Stemler J, Vaccaro O, Neaton D, Wentworth D. Diabetes and other risk factors and 12-yr crdiovascular mortality for men screend in Multiple risk intervention Trial. Diabetes Care 1993:434–44.
15
Vriese D, Verbeuren A, Van De Voorde T, J. Endothelial dysfunction in diabetes. Br J Pharmaco 2000:963–74.
16
Agiolillo D. Antiplatelet therapy in type 2 diabetes mellitus. Curr Opin Endocrinol Diabetes Obes 2007:124–31.
17
Thygesen K, Alpert J, Jaffe A, Chaitman B, Bax J, Morrow D, et al. Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/ American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction. Glob Heart 2018:305–38.
18
Selven E, Steffes M, Zhu H. Glycated Hemoglobin, diabetes, and Cardiovascular risk in nondiabetic Adults. N Engl J Med 2010:800–11.
19
Matheus A, Tannus L, Cobas R, Palma C, Negrato C, Gomes M. Impact of diabetes on cardiovascular disease: an update. Int J Hypertens 2013:653789.
20
Fuller J, Shipley M, Rose G, Jarrett R, Keen H. Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study. Br Med J (Clin Res Ed) 1983:867–70.
21
Leon B, Maddox T. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes 2015:1246–58.
22
Einarson T, Acs A, Ludwig C, Panton U. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol 2018:83.
23
Woods K, Samanta A, Burden A. Diabetes mellitus as a risk factor for acute myocardial infarction in Asians and Europeans. Br Heart J 1989:118–22.
24
Cleland J, Torabi A, Khan N. Epidemiology and management of heart failure and left ventricular systolic dysfunction in the aftermath of a myocardial infarction. Heart 2005:7–48.
25
Hodzic E, Durek A, Begic E, Sabanovic-Bajramovic N, Durak-Nalbantic A. Effect of myocardial infarction on the occurrence of erectile dysfunction. Med Glas (Zenica) 2019:5–39.
26
Higgins J, Higgins J. Elevation of cardiac troponin I indicates more than myocardial ischemia. Clin Invest Med 2003:133–47.
27
Jaffe A. Chasing troponin: how low can you go if you can see the rise? J Am Coll Cardiol 2006:1763–4.
28
Daubert M, Jeremias. The utility of troponin measurement to detect myocardial infarction: review of the current findings. Vasc Health Risk Manag 2010:691–9.
29
Sharma S, Jackson P, Makan J. Cardiac troponins. J Clin Pathol 2004:1025–6.
30
Garg P, Morris P, Fazlanie A, Vijayan S, Dancso B, Dastidar A, et al. Cardiac biomarkers of acute coronary syndrome: from history to high-sensitivity cardiac troponin. Emerg Med 2017:147–55.
31
Rafieian-Kopaei M, Setorki M, Doudi M, Baradaran A, Nasri H. Atherosclerosis: process, indicators, risk factors and new hopes. Int J Prev Med 2014:927–46.
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