PM370 Non-Invasive Molecular Ultrasound Imaging For Monitoring And Efficacy Testing Of Targeted Anti-Thrombotic Agents Using Platelet-Targeted Microbubbles
2014
Introduction: Cardiovascular disease in patients with type 2 diabetes mellitus (DM) as a cause of death is a leader in virtually all countries of the world. The risk of coronary artery disease (CAD) in patients with type 2 DM is 2-4 times higher and the risk of acute myocardial infarction is 6-10 times higher than in the general population of patients. The condition of lipid profile and vascular inflammatory reaction is of great importance when shaping coronary atherosclerotic stenosis in patients with stable angina pectoris (SAP) and DM of type 2. Objectives: Comparable evaluation of lipid profile and inflammatory markers in patients with SAP and patients with SAP and DM of type 2. Methods: A total of 97 patients with CAD (mean age 60.3 9.8 years) with nonsignificant coronary stenosis (<75%) were examined. Group I included 33 patients with SAP and DM of type 2, group II consisted of 64 patients with SAP without DM. All patients received statins, ACE inhibitors, beta blockers, dual antiplatelet therapy. In group I all patients received antihyperglycemic therapy. Lipid profile parameters (total cholesterol, triglycerides, LDL cholesterol, VLDL cholesterol, lipoprotein (a), Apo-A, Apo-B), inflammatory markers (hs-CRP, TNF-alpha, homocysteine, interleukine 1 b, 6, 8, sCD40 L, MMP-9, TIMP-1), endothelial dysfunction markers (endothelin-1, nitrites) were measured. Results: There were high levels of hs-CRP, TNF-alpha, lipoprotein (a), MMP-9, triglycerides, and endothelin-1 in both groups. The level of TIMP-1 was significantly reduced in both groups. Patients in group 1 had significantly elevated levels of total cholesterol, LDL cholesterol, homocysteine, Apo-B, Apo-B/Apo A-1 ratio, IL -1 b . In group 1 the following positive correlations were found: between glycohemoglobin and Apo-B, Apo-B/Apo A-1 ratio, homocysteine, IL -1 b, sCD40 L; IL-6 and hs-CRP; homocysteine and LDL cholesterol, MMP-9, duration of CAD; endothelin-1 and sCD40L, TNF-alpha. It was shown that with an increase of 1 mmol/L in homocysteine level and of 1 mg/l in hs–CRP level, the risk of DM in patients with SAP increased by 1.1 and 3.8 times, respectively. Conclusion: In patients with type 2 DM there was a significant increase in the levels of atherogenic lipid fractions as well as homocysteine, hs-CRP and IL-1 b which may indicate a higher risk of coronary events even in the absence of significant coronary stenosis. Disclosure of Interest: None Declared
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