Association of inflammatory markers and poor outcome in diabetic patients presenting with ST segment elevation myocardial infarction.

J Inflamm Res

Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, Kemerovo, Russian Federation ; State Budgetary Educational Institution of Higher Professional Education Kemerovo State Medical Academy of the Russian Ministry of Health, Kemerovo, Russian Federation.

Published: June 2015

Objective: Carbohydrate metabolism disorders (CMD) significantly impact the development and progression of all forms of ischemic heart disease, and inflammation is regarded as a general pathogenetic link between CMD and ischemic heart disease.

Methods: A total of 601 patients with ST segment elevation myocardial infarction (MI) (STEMI), admitted within 24 hours from the onset of symptoms during 1 year, were included in this registry study. The blood levels of inflammation markers were measured at days 10-14 with further follow up at 1 year.

Results: The analysis of acute-phase percutaneous coronary intervention impact on the 1-year outcomes showed that endovascular revascularization significantly improved the 1-year prognosis of STEMI patients both with and without CMD. The analysis of inflammation markers showed significantly higher levels of interleukin (IL)-6 and sCD40L in MI patients with diabetes mellitus, and impaired glucose tolerance. Additionally, the patients with impaired glucose tolerance had significantly higher IL-12 levels. In the diabetic MI patients, the odds ratio of a poor 1-year outcome was high for patients with a high Killip classification of acute heart failure upon admission.

Conclusion: Persistent inflammation in STEMI patients with CMD undergoing percutaneous coronary intervention might be responsible for vascular complications within 1 year after MI. Comorbid diabetes mellitus or impaired glucose tolerance can amplify the significance of the inflammatory response for the development of adverse 1-year outcomes.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446019PMC
http://dx.doi.org/10.2147/JIR.S76304DOI Listing

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