vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"vestim-401Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEСТРЕССОВАЯ ГИПЕРГЛИКЕМИЯ У ПАЦИЕНТОВ С ОСТРЫМ КРУПНООЧАГОВЫМ ИНФАРКТОМ МИОКАРДАSTRESS-INDUCED HYPERGLYCEMIA IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTIONСмирноваЕ. С.SmirnovaE. S.

Assistant

83, Dzerzhynskiy Ave., 220116

alena.sergeevna.smirnova@gmail.comГригоренкоЕ. А.GrigorenkoE. A.

Ph. D. (Med.), Assistant Professor

83, Dzerzhynskiy Ave., 220116

alegri@tut.byМитьковскаяН. П.MitkovskayaN. P.

D. Sc. (Med.), Professor, Head of the Department

83, Dzerzhynskiy Ave., 220116

mitkovskaya1@mail.ruБелорусский государственный медицинский университет, МинскBelarusian State Medical University, Minsk201709122017046069Copyright © Смирнова Е.С., Григоренко Е.А., Митьковская Н.П., 20172017Смирнова Е.С., Григоренко Е.А., Митьковская Н.П.Smirnova E.S., Grigorenko E.A., Mitkovskaya N.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/401

Изучены особенности течения острого крупноочагового инфаркта миокарда (ИМ), осложненного развитием стрессовой гипергликемии (ГГ), у 185 пациентов без нарушений углеводного обмена в анамнезе.

The objective of the present research was to reveal the features of acute myocardial infarction in patients without violations of carbohydrate metabolism in the anamnesis complicated by the development of hyperglycemia and to create a mathematical model for assessment of the development of Diabetes Mellitus 2 types in the post-myocardial infarction period.

Results for examination of 185 patients with acute large-focal myocardial infarction (MI) without previous carbohydrate metabolism disorders are presented in the article. Patients with MI and hyperglycemia (HG) were characterized by more severe systemic inflammation, hemostasis disturbances and changes in the hormonal state than patients without HG. This was associated with more severe MI progression and more prominent changes in structural and functional cardiovascular parameters. The changes in patient outcomes and homeostasis parameters have been revealed depending on the dynamics of glycemia in the acute period of MI. We have developed a mathematical model for assessment of diabetes mellitus onset risks in patients with MI and HG. 

инфаркт миокардастрессовая гипергликемияmyocardial infarctionhyperglycemiaReferencesESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) / B. Ibanez [et al.] // Eur. Heart J. – 2017. – ehx637.Ibanez B., James S., Agewall S., Antunes M. J., Bucciarelli-Ducci C., Bueno H., Caforio A. L. P., Crea F., Goudevenos J. A., Halvorsen S., Hindricks G., Kastrati A., Lenzen M. J., Prescott E., Roffi M., Valgimigli M., Varenhorst C., Vranckx P., Widimský P. ESC guidelines for the management of acute myocardial infarction in patients presenting with STsegment elevation: The task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal, 2017, ehx637. DOI: 10.1093/eurheartj/ehx637Hyperglycemia and acute coronary syndrome. A scientific statement from the american heart association diabetes committee of the council on nutrition, physical activity, and metabolism / P. Deedwania [et al.] // Circulation. – 2008. – Vol. 117, N 12. – P. 1610–1619.Deedwania P., Kosiborod M., Barrett E., Ceriello A., Isley W., Mazzone T., Raskin P. hyperglycemia and acute coronary syndrome. A scientific statement from the american heart association diabetes committee of the council on nutrition, physical activity, and metabolism. Circulation, 2008, vol. 117, no. 12, pp. 1610–1619.Предикторы неблагоприятных исходов чрескожных коронарных вмешательств у пациентов с острым инфарктом миокарда с подъемом сегмента ST / Н.П. Митьковская [и др.] // Мед. панорама. – 2012. – №4. – С. 3–5.Mit’kovskaya N. P., Abel’skaya I. S., Postoyalko A. S., Statkevich T. V., Galitskaya S. S., Smirnova E. S., Balysh E. M., Samoliuk B. B. Predictors of adverse outcomes of percutaneous coronary interventions in patients with acute myocardial infarction with segment elevation ST. Meditsinskaya panorama [Medical Panorama], 2012, no. 4, pp. 3–5 (in Russian).Интервенционная кардиология. Коронарная ангиография и стентирование : практ. рук. / А.П. Савченко [и др.]. – М. : ГЭОТАР-Медиа, 2010. – 448 с.Savchenko A. P., Cherkavskaia O. V., Rudenko B. A., Bolotov P. A. Interventional cardiology. Coronary angiographyand stenting: practical guide. Moscow, GEOTAR-Media Publ., 2010. 448 p. (in Russian).Шахнович, Р.М. Острый коронарный синдром с подъемом сегмента ST : рук. для врачей / Р.М. Шахнович. – М. : ГЭОТАР-Медиа, 2010. – 376 с.Shakhnovich R. M. Acute coronary syndrome with ST segment elevation: guide for doctors. Moscow, GEOTARMedia Publ., 2010. 376 p. (in Russian).Normal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials / G. Stone [et al.] // Circulation. – 2001. – Vol. 104, N 6. – P. 636–641.Stone G. W., Cox D., Garcia E., Brodie B. R., Morice M. C., Griffin J., Mattos L., Lansky A. J., O’Neill W. W., Grines C. L. Normal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials. Circulation, 2001, vol. 104, no. 6, pp. 636–641.Cardiovascular mortality and heart failure risk score for patients after ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention (data from the leiden mission infarct registry) / M.L. Antoni [et al.] // Am. J. Cardiol. – 2012. – Vol. 109, N 2. – P. 187–194.Antoni M. L., Hoogslag G. E., Boden H., Liem S. S., Boersma E., Fox K., Schalij M. J., Bax J. J., Delgado V. Cardiovascular mortality and heart failure risk score for patients after ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention (data from the leiden mission infarct registry). American Journal of Cardiology, 2012, vol. 109, no. 2, pp. 187–194.Нечесова, Т.А. Ремоделирование левого желудочка: патогенез и методы оценки / Т.А. Нечесова, И.Ю. Коробко, Н.И. Кузнецова // Мед. новости. – 2008. – №11. – С. 7–13. 9. Хайрутдинова, Г. Диагностические критерии ремоделирования левого желудочка у больных после перенесенного инфаркта миокарда с зубцом Q / Г. Хайрутдинова, А. Галявич // Практ. медицина. – 2011. – №4. – С. 75–79.Nechesova T. A., Korobko I. Yu., Kuznetsova N. I. Remodeling of the left ventricle: pathogenesis and evaluation methods. Meditsinskie novosti [Medical News], 2008, no. 11, pp. 7–13 (in Russian).Cardiovascular mortality and heart failure risk score for patients after ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention (data from the leiden mission infarct registry) / M.L. Antoni [et al.] // Am. J. Cardiol. – 2012. – Vol. 109, N 2. – P. 187–194.Khairutdinova G., Galiavich A. Diagnostic criteria for left ventricular remodeling in patients after a previous myocardial infarction with a merlon. Prakticheskaya meditsina [Practical Medicine], 2011, no. 4, pp. 75–79 (in Russian).Оранский, П. Уровни цитокинов у больных Q-позитивным инфарктом миокарда в сыворотке крови и куль- турах мононуклеаров крови / П. Оранский, Р. Ханферян // Цитокины и воспаление. – 2009. – Т. 8, №2. – С. 31–33.Antoni M. L., Hoogslag G. E., Boden H., Liem S. S., Boersma E., Fox K., Schalij M. J., Bax J. J., Delgado V. Cardiovascular mortality and heart failure risk score for patients after ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention (data from the leiden mission infarct registry). American Journal of Cardiology, 2012, vol. 109, no. 2, pp. 187–194. DOI: 10.1016/j.amjcard.2011.08.029Inflammatory responses after percutaneous coronary intervention in patients with acute myocardial infarction or stable angina pectoris / S. Solheim [et al.] // Scand. J. Clin. Lab. Invest. – 2008. – Vol. 68, N 7. – P. 555–562.Oranskii P., Khanferian R. Cytokine levels in patients with Q-positive myocardial infarction in serum and cultures of blood mononuclear cells. Tsitokiny i vospalenie [Cytokines and Inflammation], 2009, vol. 8, no. 2, pp. 31–33 (in Russian). DOI: 10.1016/j.amjcard.2011.08.029Ceriello, A. Cardiovascular effects of acute hyperglycaemia: pathophysiological underpinnings / A. Ceriello // Diab. Vasc. Dis. Res. – 2008. – Vol. 5, N 4. – P. 260–268.Solheim S., Grøgaard H. K., Hoffmann P., Arnesen H., Seljeflot I. Inflammatory responses after percutaneous coronary intervention in patients with acute myocardial infarction or stable angina pectoris. Scandinavian Journal of Clinical and Laboratory Investigation, 2008, vol. 68, no. 7, pp. 555–562.Использование биомаркеров-цитокинов в диагностике и прогнозировании течения инфаркта миокарда / М.В. Зыков [и др.] ; КемГМА Минздравсоцразвития, Ин-т комплексных проблем сердечно-сосудистых заболеваний ; под общ. ред. М.В. Зыкова. – Кемерево, 2012. – 24 с.Ceriello A. Cardiovascular effects of acute hyperglycaemia: pathophysiological underpinnings. Diabetes & Vascular Disease Research, 2008, vol. 5, no. 4, pp. 260–268. DOI: 10.3132/dvdr.2008.038Значение определения нитритов-нитратов как маркеров дисфункции эндотелия при сердечно-сосудистой патологии / Л.А. Лапшина [и др.] // Укр. мед. часоп. – 2009. – №6. – С. 49–53.Zykov M. V., Barbarash O. L., Karetnikova V. N., Kashtalap V. V. The use of biomarkers-cytokines in the diagnosis and prediction of the course of myocardial infarction. Kemerevo, 2012. 24 p. (in Russian).Hyperinsulinemia is a predictor of new cardiovascular events in Colombian patients with a first myocardial infarction / R. Garcia [et al.] // Int. J. Cardiol. – 2011. – Vol. 148, N 1. – P. 85–90.Lapshina L. A., Kravchun P. G., Titova A. Y., Glebova O. V. The value of the determination of nitrites-nitrates as markers of endothelial dysfunction in cardiovascular disease. Ukrai’ns’kyj medychnyj chasopys [Ukrainian Medical Journal], 2009, no. 6, pp. 49–53 (in Russian).Прогностическое значение повышенного уровня D-димера плазмы крови у больных острым коронарным синдромом / Панина А. В. [и др.] // Bull. of Med. Internet Conf. – 2013. – Vol. 3, N 6. – P. 954.García R. G., Rincón M. Y., Arenas W. D., Silva S. Y., Reyes L. M., Ruiz S. L., Ramirez F., Camacho P. A., Luengas C., Saaibi J. F., Balestrini S., Morillo C., López-Jaramillo P. Hyperinsulinemia is a predictor of new cardiovascular events in Colombian patients with a first myocardial infarction. International Journal of Cardiology, 2011, vol. 148, no. 1, pp. 85–90. DOI: 10.1016/j.ijcard.2009.10.030Лечебная тактика у пациентов с крупноочаговым инфарктом миокарда и гипергликемией с позиций кардио- протекции / Н.П. Митьковская [и др.] // Мед. панорама. – 2012. – №4. – С. 17–19.Panina A. V., Dovgalevskii Ya. P., Furman N. V., Puchinyan N. F., Bogomolova O. S. Prognostic value of elevated plasma D-dimer level in patients with acute coronary syndrome. Bulletin of Medical Internet Conferences, 2013, vol. 3, no. 6, p. 954 (in Russian).Aldosterone and cortisol predict medium-term left ventricular remodelling following myocardial infarction / A. Robin [et al.] // Eur. J. Heart Fail. – 2011. – Vol. 13, N 12. – P. 1305–1313.Mit’kovskaya N. P., Statkevich T. V., Smirnova E. S., Balysh E. M., Galitskaya S. S., Cherviakova T. A., Troianova N. V., Kulazhenko I. O. Therapeutic tactics in patients with large-focal myocardial infarction and hyperglycaemia in terms of cardioprotection. Meditsinskaya panorama [Medical Panorama], 2012, no. 3, pp. 17–19 (in Russian).Hormonal supplementation in endocrine dysfunction in critically ill patients / A. Dulawa [et al.] // Pharmacol. Rep. – 2007. – Vol. 59, N 2. – P. 139–149.Weir R. A., Tsorlalis I. K., Steedman T., Dargie H. J., Fraser R., McMurray J. J., Connell J. M. Aldosterone and cortisol predict medium-term left ventricular remodelling following myocardial infarction. European Journal of Heart Fail, 2011, vol. 13, no. 12, pp. 1305–1313. DOI: 10.1093/eurjhf/hfr129Wallander, M. Leptin: a predictor of abnormal glucose tolerance and prognosis in patients with myocardial infarction and without previously known Type 2 diabetes / M. Wallander, S. Soderberg, A. Norhammar // Diabet. Med. – 2008. – Vol. 25, N 8. – P. 949–955.Duława A., Bułdak Ł., Krysiak R., Okopień B. Hormonal supplementation in endocrine dysfunction in critically ill patients. Pharmacological Reports, 2007, vol. 59, no. 2, pp. 139–149.Митьковская, Н.П. Сердце и метаболический риск / Н.П. Митьковская, Е.А. Григоренко, Л.И. Данилова. – Минск : Белорус. наука, 2008. – 277 с.Wallander M., Soderberg S., Norhammar A. Leptin: a predictor of abnormal glucose tolerance and prognosis in patients with myocardial infarction and without previously known Type 2 diabetes. Diabetic Medicine, 2008, vol. 25, no. 8, pp. 949– 955. DOI: 10.1111/j.1464–5491.2008.02509.xPallan, S. Effects and mechanisms of action of leptin on cardiomyocytes [Electronic resourse] / S. Pallan // J. of Young Investigators. – 2004. – N 2. – Mode of access: http://www.jyi.org/issue/effects-and-mechanisms-of-action-of-leptinon-cardiomyocytes.html. – Date of access: 05.05.2016.Mit’kovskaya N. P., Grigorenko E. A., Danilova L. I. Heart and metabolic risk. Minsk, Belorusskaya nauka Publ., 2008. 277 p. (in Russian).Прогностическое значение и возможности коррекции гипергликемии у пациентов с острым коронарным синдромом / В.С. Моисеев [и др.] // Клин. фармакология и терапия. – 2008. – №2. – С. 65–73.Pallan S. Effects and mechanisms of action of leptin on cardiomyocytes [Electronic resourse]. Journal of Young Investigators, 2004, no. 2. Available at: http://www.jyi.org/issue/effects-and-mechanisms-of-action-of-leptin-on-cardiomyocytes.html (accessed 05.05.2016).Moiseev V. S., Mil’to A. S., Pavlikova E. P., Tolkacheva V. V. Prognostic value and the possibility of correction of hyperglycemia in patients with acute coronary syndrome. Klinicheskaya farmakologiia i terapiya [Clinical Pharmacology and Therapy], 2008, no. 2, pp. 65–73 (in Russian).Moiseev V. S., Mil’to A. S., Pavlikova E. P., Tolkacheva V. V. Prognostic value and the possibility of correction of hyperglycemia in patients with acute coronary syndrome. Klinicheskaya farmakologiia i terapiya [Clinical Pharmacology and Therapy], 2008, no. 2, pp. 65–73 (in Russian).

The authors declare that there are no conflicts of interest present.