A model for prognosis of development of left ventricular systolic dysfunction in patients with acute myocardial infarction and type 2 diabetes mellitus taking into account tenascin C level
DOI:
https://doi.org/10.14739/2310-1210.2016.2.69169Keywords:
Myocardial Infarction, Tenascin С, Diabetes Mellitus Type 2, Left Ventricular DysfunctioAbstract
The aim of the study was to elaborate a model for prediction of development of left ventricular systolic dysfunction in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus taking into account tenascin C level and estimation of predictive value of this indicator in AMI.
Methods and materials. 120 patients were included into the study. Tenascin C and troponin I were determined by ELISA method (Immuno-Biological Laboratories Co. Ltd. (IBL), Takasaki-Shi, Japan; XEMA, Moscow, Russia). Statistical processing of the results was performed with Statistica 6.0 software. Prediction properties were evaluated by ROC-curve. The model was elaborated using reduced ejection fraction (EF) in patients with AMI, analyzing indicators of lipid, carbohydrate metabolism, age, matrix metalloproteinases, tenascin C. Stepwise logistic regression method was used to allocate four indices, which may be employed for reliable accuracy prediction, namely diastolic blood pressure (DBP), creatinine, body mass index (BMI), tenascin C.
Results: Results of the study provided evidence that type 2 diabetes mellitus is associated with decompensation impact of tenascin C in patients with AMI. The study found a correlation between tenascin C and troponin I. Patients with AMI and type 2 diabetes mellitus had association between tenascin C and troponin I – r = -0.26 (p<0.05) and in AMI patients without type 2 DM – r = 0.28 (p<0.05). Consideration of tenascin C, creatinine, BMI and DBP indices in one model makes it possible to increase the specificity to 77% in high sensitivity of 89%.
Conclusion. Application of the model taking into account tenascin C level can be considered to predict development of left ventricular systolic dysfunction in patients with AMI and type 2 diabetes mellitus.
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