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Diabetes mellitus type 2 and acute myocardial infarction: prognostic options for interaction in patients of different age groups

https://doi.org/10.14341/DM8828

Abstract

Background. Problems surrounding comorbidities of type 2 diabetes mellitus and coronary heart disease are some of the most important in medical science and practice, given their mutually negative impact on patients’ prognoses and quality of life.


Aims. To study the impact of type 2 diabetes on the long-term prognoses of patients of different age categories, status-post acute myocardial infarction. (Data obtained from the ‘Register of Acute Myocardial Infarction’.)


Materials and methods. The main data source was the ‘Register of Acute Myocardial Infarction’, maintained in Tomsk for more than 30 years. The study included 862 patients with acute myocardial infarction. The patients were monitored for 5 years. The primary endpoint was death from any cause during the observation period.


Results. We separated the study cohort into 2 groups depending on patients’ ages: Group 1 (n = 358) included patients older than working age, Group 2 (n = 504) consisted of younger, employable patients. The combination of ischaemic heart disease and type 2 diabetes mellitus were diagnosed in 208 patients. The combination of ischaemic heart disease and type 2 diabetes was the cause of adverse prognosis among elderly patients and led to increased mortality rate during the 5-year post-infarction period (p = 0.0003). However, among younger, working patients who suffered myocardial infarction, the presence of type 2 diabetes did not have an independent negative effect on long-term disease prognosis. While in employable patients, a long history of diabetes mellitus significantly aggravated the course of the post-infarction period (p = 0.004).


Conclusions. These data suggest an ambiguous prognostic effect of type 2 diabetes mellitus among working age and elderly patients status post myocardial infarction, in agreement with experimental studies conducted on laboratory animals. Further comprehensive analyses of the clinical and experimental data are needed to optimise therapies for patients who suffer from type 2 diabetes and comorbid ischaemic heart disease.

About the Authors

Alla A. Garganeeva

Tomsk National Research Medical Centre, Russian Academy of Sciences


Russian Federation

MD, PhD, Professor



Elena A. Kuzheleva

Tomsk National Research Medical Centre, Russian Academy of Sciences


Russian Federation

MD, PhD



Ksenia N. Borel

Ltd. «ARMED»


Russian Federation

MD, PhD



Dina S. Kondratyeva

Tomsk National Research Medical Centre, Russian Academy of Sciences


Russian Federation

PhD in Biology



Sergey A. Afanasiev

Tomsk National Research Medical Centre, Russian Academy of Sciences


Russian Federation

MD, PhD, Professor



References

1. Белов В.Б., Роговина А.Г. Основные медико-демографические показатели здоровья населения России к 2013 г. // Проблемы социальной гигиены, здравоохранения и истории медицины. – 2014. – №6. – С. 18-22. [Belov VB, Rogovina AG. The basic medical demographic indicators of population health of Russia up to 2013. Problems of social hygiene, public health and history of medicine. 2014;(6):18-22. (In Russ.)]

2. Жернакова Ю.В., Чазова И.Е. Управление сердечно-сосудистыми рисками у больных сахарным диабетом // Системные гипертензии. – 2016. – Т. 13. – №3. – С. 43-47. [Zhernakova YV, Chazova IE. Control of cardiovascular risk in patients with diabetes. Systemic Hypertension.2016;13(3):43-47. (In Russ.)]

3. Дедов И.И., Шестакова М.В., Майоров А.Ю., и др. Клинические рекомендации «Алгоритмы специализированной медицинской помощи больным сахарным диабетом». / Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова – 8-й выпуск // Сахарный диабет. – 2017. – Т. 20. – №1S. – С. 1-112. [Dedov II, Shestakova MV, Mayorov AY, et al. Dedov II, Shestakova MV, Mayorov AY, editors. Standards of specialized diabetes care. 8th edition. Diabetes mellitus. 2017;20(1S):1-112. (In Russ.)] doi: 10.14341/DM20171S8

4. Дедов И.И., Шестакова М.В., Викулова О.К. Государственный регистр сахарного диабета в Российской Федерации: статус 2014 г. и перспективы развития // Сахарный диабет. – 2015. – Т. 18. – №3. – С. 5-22. [Dedov II, Shestakova MV, Vikulova OK. National register of diabetes mellitus in Russian Federation. Diabetes mellitus. 2015;18(3):5-22. (In Russ.)] doi: 10.14341/DM201535-22

5. Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ. 2006;332(7533):73-78. doi: 10.1136/bmj.38678.389583.7C

6. Гарганеева А.А., Округин С.А., Борель К.Н., и др. Инфаркт миокарда на рубеже двух столетий: демографические и социальные тенденции // Клиническая медицина. – 2016. – Т. 94. – №6. – С. 463-466. [Garganeeva AA, Okrugin SA, Borel KN, et al. Myocardial infarction at the border of two centuries: demographic and social tendencies. Klin Med (Mosk). 2016;94(6):463-466. (In Russ.)] doi: 10.18821/0023-2149-2016-94-6-463-466

7. Богомолов А.Н., Козлов К.Л., Курочкина О.Н. Выживаемость пожилых больных, перенесших стентирование коронарных артерий в острый период инфаркта миокарда: ретроспективный анализ // Успехи геронтологии. – 2012. – Т. 25. – №3. – С. 468-473. [Bogachev AA, Kozlov KL, Kurochkina ON. Survival of elderly patients after coronary stenting in acute myocardial infarction during the eight years of observation: retrospective analyses. Adv Gerontol. 2012;25(3):468-473. (In Russ.)]

8. Марцевич С.Ю., Гинзбург М.Л., Кутишенко Н.П., и др. Люберецкое исследование по изучению смертности больных, перенесших острый инфаркт миокарда. Первые результаты исследования «ЛИС» // Клиницист. – 2011. – №1. – С. 24-27. [Martsevich SY, Ginzburg ML, Kutishenko NP, et al. A Lyubertsy study of mortality among patients with prior acute myocardial infarction: the first results of the LIS study. Clinician. 2011;(1):24-27. (In Russ.)]

9. Шульман В.А., Головенкин С.Е., Симулин В.Н., и др. Сравнительная оценка ближайшего и отдаленного прогноза больных инфарктом миокарда в зависимости от наличия и времени возникновения патологического зубца Q // Рациональная фармакотерапия в кардиологии. – 2010. – Т. 6. – №6. – С. 812-817. [Shulman VA, Golovenkin SE, Simulin VN, et al. Prognostic value of pathologic Q-wave and time of its appearance in patients with myocardial infarction: comparison study. Rational pharmacotherapy in cardiology. 2010;6(6):812-817. (In Russ.)]

10. Nauta ST, Deckers JW, Akkerhuis KM, van Domburg RT. Short- and long-term mortality after myocardial infarction in patients with and without diabetes: changes from 1985 to 2008. Diabetes Care. 2012;35(10):2043-2047. doi: 10.2337/dc11-2462

11. Young ME. Adaptation and Maladaptation of the Heart in Diabetes: Part II: Potential Mechanisms. Circulation. 2002;105(15):1861-1870. doi: 10.1161/01.cir.0000012467.61045.87

12. Waczulikova I, Ziegelhoffer A, Orszaghova Z, Carsky J. Fluidising effect of resorcylidene aminoguanidine on sarcolemmal membranes in streptozotocin-diabetic rats: blunted adaptation of diabetic myocardium to Ca2+ overload. J Physiol Pharmacol. 2002;53(4 Pt 2):727-739.

13. Ziegelhöffer-Mihalovičová B, Waczulíková I, Šikurová L, et al. Remodelling of the sarcolemma in diabetic rat hearts: the role of membrane fluidity. Mol Cell Biochem. 2003;249(1-2):175-182. doi: 10.1023/a:1024703226034

14. Afanasiev SA, Kondratieva DS, Rebrova TY, et al. Coupling of the Functional Stability of Rat Myocardium and Activity of Lipid Peroxidation in Combined Development of Postinfarction Remodeling and Diabetes Mellitus. J Diabetes Res. 2016;2016:1-6. doi: 10.1155/2016/2548689

15. Афанасьев С.А., Кондратьева Д.С., Канев А.Ф., и др. Различия в динамике зависимости «интервал-сила» изолированного миокарда человека с ишемической болезнью сердца на фоне и без сахарного диабета 2 типа, роль Са2+-АТФ-азы саркоплазматического ретикулума // Физиология человека. – 2017. – Т. 43. – №1. – С. 63-69. [Afanasiev SA, Kondratyeva DS, Kanev AF, et al. Differences in the Force-Interval Relationship of Isolated Human Myocardium with Chronic Coronary Artery Diseasein Patients with and without Type 2 Diabetes Mellitus and the Role of Ca2+-ATPase of Sarcoplasmic Reticulum. Fiziol Cheloveka. 2017;43(1):63-69. (In Russ.)] doi: 10.7868/S0131164616060023

16. Heusch G, Libby P, Gersh B, et al. Cardiovascular remodelling in coronary artery disease and heart failure. The Lancet. 2014;383(9932):1933-1943. doi: 10.1016/s0140-6736(14)60107-0

17. Mondesir FL, Brown TM, Muntner P, et al. Diabetes, diabetes severity, and coronary heart disease risk equivalence: REasons for Geographic and Racial Differences in Stroke (REGARDS). Am Heart J. 2016;181:43-51. doi: 10.1016/j.ahj.2016.08.002

18. Rana JS, Liu JY, Moffet HH, et al. Diabetes and Prior Coronary Heart Disease are Not Necessarily Risk Equivalent for Future Coronary Heart Disease Events. J Gen Intern Med. 2016;31(4):387-393. doi: 10.1007/s11606-015-3556-3

19. Mladenovic V, Zdravkovic V, Jovic M, et al. Influence of admission plasma glucose level on short- and long-term prognosis in patients with ST-segment elevation myocardial infarction. Vojnosanit Pregl. 2010;67(4):291-295. doi: 10.2298/vsp1004291m

20. Malfitano C, Alba Loureiro TC, Rodrigues B, et al. Hyperglycaemia protects the heart after myocardial infarction: aspects of programmed cell survival and cell death. Eur J Heart Fail. 2010;12(7):659-667. doi: 10.1093/eurjhf/hfq053

21. Malfitano C, Barboza CA, Mostarda C, et al. Diabetic hyperglycemia attenuates sympathetic dysfunction and oxidative stress after myocardial infarction in rats. Cardiovasc Diabetol. 2014;13:131. doi: 10.1186/s12933-014-0131-x

22. Desrois M, Clarke K, Lan C, et al. Upregulation of eNOS and unchanged energy metabolism in increased susceptibility of the aging type 2 diabetic GK rat heart to ischemic injury. Am J Physiol Heart Circ Physiol. 2010;299(5):H1679-1686. doi: 10.1152/ajpheart.00998.2009

23. Шляхто Е.В. Молекулярные и генетические аспекты сердечной недостаточности при сахарном диабете // Вестник Российской академии медицинских наук. – 2012. – №1. – С. 31-37. [Shlyakhto ЕV. Molecular and genetic aspects of heart failure in diabetic patients. Annals of the Russian Academy of Medical Sciences. 2012;(1):31-37. (In Russ.)]


Supplementary files

1. Рисунок 1 - Динамика уровня летальности от острого инфаркта миокарда в период аномально жаркой погоды
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2. Рисунок 2 - Влияние наличия сахарного диабета на отдаленный прогноз заболевания у пациентов трудоспособного возраста, перенесших инфаркт миокарда
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3. Рисунок 3 - Выживаемость больных, перенесших острый инфаркт миокарда, в зависимости от длительности сахарного диабета
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4. Fig.1. Effect of CD2 on the long-term prognosis of the disease in patients older than working age who underwent myocardial infarction.
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5. Fig.2. The effect of the presence of DM2 on the long-term prognosis of the disease in patients of working age who underwent myocardial infarction.
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6. Fig.3. Survival of patients with acute myocardial infarction, depending on the duration of diabetes mellitus.
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Review

For citations:


Garganeeva A.A., Kuzheleva E.A., Borel K.N., Kondratyeva D.S., Afanasiev S.A. Diabetes mellitus type 2 and acute myocardial infarction: prognostic options for interaction in patients of different age groups. Diabetes mellitus. 2018;21(2):105-112. (In Russ.) https://doi.org/10.14341/DM8828

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ISSN 2072-0351 (Print)
ISSN 2072-0378 (Online)