MONOCYTARY RESPONSE DURING ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS DEPENDING ON THE SEVERITY OF CORONARY ATHEROSCLEROSIS

Abstract

The development of atherosclerosis is associated with chronic inflammation in the vascular wall, which is realized through CD14(+ +)CD16(-) and CD14(+)CD16(+ +) monocytes. Hyperglycemia leads to pro - inflammatory changes in the monocyte system. Type 2 diabetes mellitus (DM2T) and chronic inflammation are associated with more severe atherosclerotic changes in coronary arteries (CA) and high risk of atherothrombosis in CA. Materials and methods. The observational study included 115 patients with DM2T and myocardial infarction (MI), that were undergone coronary angiography. The severity of CA atherosclerotic injury was carried out according to the SYNTAX Score scale followed by a decision on the appropriate surgical tactics. On days 1, 3, 5, and 12 ± 1, the total number of monocytes and their CD16(+) and CD16(-) subpopulations in peripheral blood were determined by cytometry. Results. Patients were divided into 3 groups depending on the level of SYNTAX Score: 47 patients at low risk (≤ 22 points), 31 patients at intermediate risk (23-32 points), 37 patients at high risk (≥ 33 points). In the low - risk group, there were significantly more patients with CA thrombosis (53 % - 25 cases) compared to high - risk patients (24.3 % - 9 cases), p = 0.015. The number of CD16(-) monocytes during the observation period did not significantly differ between the groups. The low - risk group of patients was characterized by lower CD16(+) monocyte values compared to the intermediate and high - risk groups: 37.76 (29.24; 43.20) cells/µL vs 54.79 (43.36; 111.56) cells/µl (p = 0.037); 37.76 (29.24; 43.20) cells/µl vs 62.13 (40.18; 88.04) cells/µl (p = 0.047), respectively. In DM2T patients without CA thrombosis, the SYNTAX Score level moderately positively correlated with CD16(+) monocytes on the 1st day of MI: R = 0.505, p = 0.023. Conclusions. In patients with DM2T and MI, more severe atherosclerotic lesions of the coronary arteries (SYNTAX Score 23 points and above) are associated with higher values of CD16(+) monocytes on the 1st day of MI. The data obtained support the existence of a relationship between hyperglycemia, the pro - inflammatory phenotype of monocytes, and the severity of coronary artery atherosclerosis in patients with DM2T and MI.