AN ALGORITHM FOR PROGNOSIS OF RECURRENT MYOCARDIAL INFARCTION IN TYPE 2 DIABETES MELLITUS PATIENTS FOLLOWING DETERMINATION OF ENDOTHELIAL DYSFUNCTION MARKERS.

The combination of cardiac pathology and metabolic disorders, namely type 2 diabetes mellitus, is one of the most frequent comorbid pathologies and the main cause of death from cardiovascular complications at an early stage of the disease. Despite the wide range of antithrombogenic measures, prevention of thrombotic complications of acute myocardial infarction remains an urgent problem of cardiology. The study involved examination of 73 patients with acute myocardial infarction with concomitant type 2 diabetes mellitus, who were distributed into clusters according to severity by the main indices of lipid and carbohydrate metabolism using hierarchical analysis. 43 patients (3 persons from Cluster 1 and 40 from Cluster 2) had complications in the form of recurrent myocardial infarction. The study implied elaboration of the system of recurrent myocardial infarction in patients with type 2 diabetes mellitus, involving a group of classifiers based on a discriminant model and a scoring system of prediction. Routine indices (insulin, cholesterol, EDV, creatinine phosphokinase) and specific markers (asymmetric dimethylarginine and type 1 plasminogen activator inhibitor) were used as predictors. The system of mathematical prediction of recurrent myocardial infarction has a high sensitivity (84.1%) and specificity (93.1%) with a total accuracy of 87.7%, which allows it to be used in modern clinical practice to prevent the occurrence of undesirable cardiovascular events.