Indexes of left ventricle contractive function in persons after acute coronary event, depending on the presence of diabetes mellitus and sodium-glucose transporter inhibitors type 2 use


DOI: https://dx.doi.org/10.18565/therapy.2023.8.28-36

Nevzorova V.A., Semenova P.A., Zakharchuk N.V., Ivina A.V.

1) Pacific National University of the Ministry of Healthcare of Russia, Vladivostok; 2) RVC of Vladivostok Clinical Hospital No. 1
Abstract. Various studies have provided unquestionable evidence of a close interaction between cardiovascular events and diabetes mellitus (DM).
The aim: to evaluate the condition of left ventricle (LV) function and NTproBNP level in patients with acute coronary syndrome (ACS) on the first day of hospitalization and after 6 months of observation, depending on the presence of diabetes and the options of therapy that was used.
Material and methods. The study involved 100 patients aged from 35 to 65 years, hospitalized in the RVC of Vladivostok clinical hospital No. 1 with ACS diagnosis. For all of them laboratory and instrumental diagnostic methods for ACS, including ECG, echocardiography, and invasive coronary angiography were performed. Also, in the first hours of admission to the hospital, the marker of myocardial damage (TRI) and the marker for assessing the functional state of the contractile potential of the heart muscle (NT-proBNP) were assessed. At a follow-up visit after 6 months, patients underwent echocardiography and the content of NT-proBNP in blood serum was examined.
Results. A close inverse correlation was revealed between LVEF and the level of NTproBNP: 6 months after the ACS development, with an increase in LVEF by 1%, a decrease in NTproBNP by 45,9 ng/l in patients is predicted (ρ=0,4, p=0,002). An increase in LVEF occurred in all patients with ACS history, but this change was mostly observed in patients with STEMI having diabetes and LVEF <40%. Following to recommended complex therapy including sodium-glucose transporter type 2 inhibitors contributed to an increase in LVEF in all patients who had myocardial infarction (MI): after 6 months of observation, there were no patients with reduced LVEF among the persons from study group, in presence of an increase in the number of patients with intermediate and preserved LVEF.
Conclusion. Patients with MI and a recent history of diabetes had the most statistically significant decrease in LVEF and increase in NTproBNP. After 6 months of observation, while taking the prescribed therapy, a positive effect was observed in the form of an increase in LVEF in patients with STEMI and diabetes, with NSTEMI and diabetes, and also in patients with NSTEMI without diabetes.
Keywords: sodium-glucose cotransporter type 2 inhibitors, acute coronary syndrome, diabetes mellitus, chronic heart failure
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About the Autors

Vera A. Nevzorova, MD, chief therapist of the Far Eastern Federal District, director of the Institute of therapy and instrumental diagnostics, Pacific National University of the Ministry of Healthcare of Russia. Address: 690002, Vladivostok, 2 Ostryakova St.
E-mail: nevzorova@inbox.ru@gmail.com
ORCID: https://orcid.org/0000-0002-0117-0349
Polina A. Semenova, graduate student of the Institute of therapy and instrumental diagnostics, Pacific National University of the Ministry of Healthcare of Russia, cardiologist at RVC Vladivostok Clinical Hospital No. 1. Address: 690002, Vladivostok, 2 Ostryakova St.
E-mail: polina.selyukova@gmail.com
ORCID: https://orcid.org/0000-0002-3632-9575
Natalya V. Zakharchuk, MD, professor of the Institute of therapy and instrumental diagnostics, Pacific National University of the Ministry of Healthcare of Russia. Address: 690002, Vladivostok, 2 Ostryakova St.
E-mail: zaharchuknat@mail.ru
ORCID: https://orcid.org/0000-0002-5809-3989
Anna V. Ivina, 6th year student of the specialty 05/31/01 «General medicine», Pacific National University of the Ministry of Healthcare of Russia. Address: 690002, Vladivostok, 2 Ostryakova St.
E-mail: anna_d17_00@mail.ru


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