Эволюция инсулинорезистентности на примере больных инфарктом миокарда с подъемом сегмента ST

The purpose of this study was to evaluate the prevalence of insulin resistance (IR) and first encountered disorders of carbohydrate metabolism (HMD) in patients with myocardial infarction with elevation ST (IMspST) and define the role of R&D stages of evolution in the early and late postinfarction period.The study was conducted among men who have had MI who had no history of DCM (including undiagnosed), confirmed figures HbA1s. We studied the prevalence of IR, and to manifest the first DCM against MI. Hospital complications were analyzed period MI and cardiovascular events in patients following year, at different stages of progression of IR and conducted a comparative assessment of the impact IR and IR combination with DCM in during the early and late postinfarction period MI. The presence of IR was detected in 69% of patients, 45.1% of DCM in the patient. By yearend DCM remained at 88.6% of patients and first appeared in 3.7% of patients. DCM revealed more often in the presence of IR 69.5%, than in patients with normal sensitivity to insulin 17.0%, p=0.000. It is established that IR adversely affects both the early and late in the forecast MI: аcute heart failure Killip II-IV diagnosed in one in six, and decompensation of heart failure within one year after MI one in five patients with IR. Joining the IR increases the number of complications of DCM MI 18.3%: acute heart failure by 37.3%, early postinfarction angina 16.9%, recurrence of MI by 18.3% and the number of subsequent cardiovascular events for 55.7%: hospitalizations for unstable angina by 62.4%, the combined events by 59.2%. Identification and correction of DCM and IR in patients with MI a condition preventing early and late complications.