PECULIARITIES OF CARBOHYDRATE AND LIPID CHANGES IN THE CASE OF DIFFERENT VARIANTS OF THE UNWANTED OVERCOMING OF HEART DEFECTS IN PATIENTS WITH CORONARY HEART DISEASE IN COMBINATION WITH TYPE 2 DIABETES

Probl bezperervnoï med osv nauki. 2019; 35(3): 73-79.
https://doi.org/10.31071/promedosvity2019.03.073

Nowadays it`s very promising to find out simple measurements of early signs of CHF progression , which allow to separate patients with high risk of unfavorable outcome of IHD and DM type II, and do this with high sensitivity and specificity. This will allow to provide appropriate treatment in time, decrease complications rate, and also help with proper medical and social services planning. The objective of the study: investigate changes in carbohydrate and lipid panel in different types of unfavorable chronic heart failure outcomes among patients that have ischemic heart disease and diabetes mellitus type II
After conventional in-hospital treatment examination of 34 males that have ischemic CHF with IHD and DM type II. Patients were divided in three groups depending on CHF progression degree during observational period: I (N = 7) — exitus letalis, II (N = 13) — with LV EF decreased, III (N = 14) — with signs of dyastolic disfunction.
Complaints, cardiologycal anamnesis, physical examination data, serum glycated hemoglobin (HbA1c), serum glucose level, insulin plasma level were assessed, homeostatic model assessment index (HOMA-ir). Levels of total cholesterol (TC), high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides (TG) was measured, also we calculate aterogenity index (AI).
In order to identify differences between independent samples was used Mann-Whitney U-criteria. Frequency of signs occurrence in groups was compared by χ2 criteria.
Observational period was 12 months. All patients recieved conventional treatment. In group I, unfavorable outcome was strongly associated with age, longer history of IHD and DM type II, impaired physical exertion tolerance, high level of arterial hypertension. Last one is proven potential cause of CHF.
Оutcome of CHF among patients with IHD and DM type II with preserved LV EF in case of death is strongly associated with duration of IHD and DM type II, higher arterial hypertension level.

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