Background : Inflammation plays a significant role in atherosclerosis progression which may result in acute myocardial infarction, and diabetes can lead to overproduction of inflammatory cytokines. We compared the levels of the various inflammatory markers and insulin resistance among the 3 groups: type 2 diabetes (DM) with ST elevation myocardial infarction (STEMI), DM with stable angina, and non-DM with STEMI.
Methods : DM with STEMI (n=73), DM with stable angina (n=79), and non-DM with STEMI (n=42) were retrospectively enrolled in the study. Venous blood samples were taken from each patient before coronary intervention. Inflammatory markers such as hsCRP, ESR, IL-6, IL-18, and VCAM, lipid profiles, and insulin resistance were compared among 3 groups.
Results : Inflammatory markers such as hsCRP (13.00±3.51 vs. 7.39±2.59, 3.83±1.40 mg/L p<0.001, respectively) were significantly higher in the DM with STEMI group when compared to the DM with stable angina and the non-DM with STEMI groups. ESR levels were higher in the DM with STEMI group than the non-DM with STEMI group (18.13±4.01 vs. 9.05±3.43 mm/hr p=0.008 respectively); IL-6 levels were higher in the DM with STEMI group than the DM with stable angina group (4.47±0.87 vs. 2.70±0.68 pg/mL p=0.005 respectively); IL-18 levels were higher in the DM with STEMI group than the non-DM with STEMI group (247.84±31.12 vs. 188.32±20.96 pg/mL p=0.006 respectively). However, VCAM levels were higher in the DM with stable angina than the DM with STEMI group (611.76±55.57 vs. 500.68±67.98 ng/mL p=0.029 respectively). Inflammatory marker levels were similar between the DM with stable angina group and the non-DM STEMI group (hsCRP; 7.39 ± 2.59 vs. 3.83 ± 1.40 mg/L, ESR; 14.77 ± 3.38 vs. 9.05 ± 3.43 mm/hr, IL-6; 2.70 ± 0.68 vs. 3.98 ± 1.02 pg/mL, IL-18; 206.76 ± 18.95 vs. 188.32 ± 20.96 pg/mL, VCAM; 611.76 ± 55.57 vs. 549.49 ± 61.60 ng/mL respectively). HOMA index was significantly higher in the DM with STEMI group than the DM with stable angina group (49.30 ± 17.46 vs. 22.40 ± 5.03 p=0.004 respectively).
Conclusions : DM with STEMI revealed the most severe inflammatory condition than DM with stable angina or non-DM with STEMI. Moreover, DM with stable angina and non-DM with STEMI demonstrated similar inflammatory levels.
