SPECIFIC PREDICTORS OF METABOLIC MYOCARDIAL ISCHEMIA IN CARBOHYDRATE METABOLISM DISORDERS

Disorders of carbohydrate metabolism in patients with acute coronary events are considered an important component of prognosis. Mortality from diseases of the cardiovascular system is estimated as high (570 cases per 100 thousand population in Russia). In 25-50% of cases of acute myocardial infarction, hyperglycemia develops, often in individuals who do not have type 2 diabetes mellitus. The aim of the review is to consider the role of factors associated with the risk of developing acute myocardial infarction in individuals with impaired carbohydrate metabolism. The literature was studied in the databases Web of Science PubMed, Web of Science, eLibrary.Ru and «CyberLeninka», eLibrary.Ru and «CyberLeninka» in Russian and English. Publications were examined from January 1, 2017 to June 1, 2024. Nonspecific predictors (arterial hypertension, dyslipidemia, abdominal obesity, smoking, low physical activity, gender, menopause, age) associated with type 2 diabetes have an independent negative effect on the cardiovascular system and the ability to increase the atherogenicity of nonspecific factors. Specific factors of diabetes associated with ACS include a significant increase in the Q-T interval during acute hyperglycemia, a decrease in ischemic preconditioning, and the phenomenon of non-restored coronary blood f low (no-reflow). The main effect of metabolic ischemia in AMI is associated with a decrease in the contractility of the remaining viable myocardium. Conclusion. Specific factors of type 2 diabetes mellitus have an independent negative impact on the potential for the development of acute myocardial infarction and enhance the role of nonspecific population risk factors for the pathology of cardiovascular diseases.