ASSOCIATION OF MARKERS OF LOW-GRADE INFLAMMATION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION WITH TYPE 2 DIABETES MELLITUS: A COMPARATIVE ANALYSIS

Abstract

Introduction. ST-elevated myocardial infarction (STEMI) remains a significant global health issue and early recognition and management are crucial for reducing damage and improving patient outcomes. Type 2 diabetes mellitus (T2DM), a common metabolic disorder, is linked to STEMI due to factors like insulin resistance, oxidative stress, and low-grade inflammation. Aim. To determine the relationship between T2DM and low-grade inflammation markers in patients with STEMI by comparing the levels of systemic immuneinflammation indices, fibronectin, and soluble sST2 in STEMI patients with and without T2DM.Materials and methods. We enrolled 131 patients diagnosed with STEMI and T2DM who were admitted to the Ivano-Frankivsk Regional Clinical Cardiological Center. The study population was divided into two groups: 1st - consisting of 97 patients with both STEMI and T2DM, and the 2nd - consisting of 34 patients with STEMI only.Results. The Systemic immune‐inflammation index (SII) (2074.50 (1838.45;2331.05) vs 1504.85 (1342.00;1943.38)), Neutrophil‐to‐lymphocyte ratio (NLR) (7.80 (7.10;8.60) vs 6.30 (5.80;8.60), p=0.002), and Aggregate index of systemic inflammation (AISI) (699.45±433.53 vs 531.80±217.27, p=0.033) were significantly higher in patients with STEMI and T2DM compared to patients with STEMI alone. Also, the levels of fibronectin (2.76±0.33 vs 2.53±0.44 ng/mL, p=0.002) and sST2 (23.06±1.19 vs 20.93±1.63 ng/mL, p=0.000) were higher in patients with STEMI and T2DM compared to patients with STEMI alone. The Platelet‐to‐lymphocyte ratio (PLR) (226.01±48.58 vs 224.19±59.61) and Systemic immune-inflammation index (SIRI) (2.59±1.54 vs 2.34±0.98) were not significantly different between the two groups. SII showed a very significant association with the 1st group (OR = 1.004 (1.002-1.005), p<0.001), NLR showed a significant positive association with the 1st group (OR = 1.647, 95% CI = 1.138-2.382, p = 0.008). The other markers showed no significant associations. Fibronectin (OR = 4.524, 95% CI = 1.646-12.430, p = 0.003) and sST2 (OR = 3.594, 95% CI = 2.203-5.864, p < 0.001) were both positively associated with the 1st group. Conclusions. Factors such as age, BMI, and markers of inflammation (SII, sST2, NLR) were significantly linked to T2DM in patients with STEMI. sST2 and SII were found to be better predictors of T2DM compared to other markers of inflammation. These results emphasize the importance of considering multiple factors in evaluating T2DM risk in STEMI patients.