CLINICAL AND PATHOGENETIC FEATURES AND DIAGNOSIS OF CORONARY HEART DISEASE IN DIABETIC PATIENTS WITH CORONAVIRUS INFECTION

The aim of the work: to identify clinical and pathogenetic features and improve the diagnosis of coronary heart disease combined with type 2 diabetes mellitus in patients who have su—ered from coronavirus infection. Material and methods. 120 patients with stable coronary artery disease combined with DM were examined. The patients were divided into two groups: the main group (history of COVID) and the comparison group (without COVID). Laboratory tests determined highly sensitive C-reactive protein (HCRP), D-dimer, vascular endothelial growth factor (VEGF-A), plasma lipid spectrum and indicators of antioxidant protection of the body, and instrumental electrocardiography, a test with metered physical activity on a treadmill, daily Holter electrocardiography monitoring, ultrasound examination of the brachial artery to determine endothelium dependent vasodilation. The clinical picture of coronary heart disease combined with type 2 diabetes in patients who have been infected with SARS-CoV-2 is characterized by a higher level of o–ce blood pressure, increased cardiac, psychosomatic and metabolic disorders. The results of the study indicate that coronary heart disease combined with type 2 diabetes in patients who have been infected with SARS-CoV-2 in 56.2% of cases occurs in the form of painless myocardial ischemia, manifested by an increase in the maximum degree of ST segment depression and the duration of its episodes, as well as an increase in daily myocardial ischemia with a decrease in the threshold heart rate during attacks. Laboratory parameters in these patients are characterized by dyslipidemia, an increase in the content of VEGF-A, an increased level of D-dimer and (an indicator of in˜ammation) HCRP, and a signi†cant decrease in the antioxidant activity of blood plasma. Conclusions. Coronary heart disease in patients with type 2 diabetes who had COVID, in 56.2% of cases, occurred in the form of painless myocardial ischemia and was accompanied by the occurrence of cardiac, psychosomatic (astheno-neurotic and asthenovegetative syndromes) and metabolic disorders. In the post-covid period, these patients had impaired lipid metabolism, an increase in VEGF-A with pronounced endothelial dysfunction, an increase in D-dimer and HCRP with a decrease in the total antioxidant activity of blood plasma.