STUDY OF LIPID AND CARBOHYDRATE METABOLISM CHARACTERISTICS IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER REVASCULARIZATION

Objective. To study the contribution to the determination of residual risk in patients with coronary artery disease (CAD) after myocardial revascularization, from the perspective of carbohydrate and fat metabolism. Materials and methods. The study included 115 patients with IHD who underwent percutaneous coronary interventions and/or aortocoronary bypass surgery. Depending on the presence of type 2 diabetes mellitus (T2DM), patients were divided into two groups: without T2DM (n=59) and with T2DM (n=56). All patients underwent clinical and laboratory examinations to determine lipid profile and carbohydrate metabolism indicators, biomarkers of inflammation and endothelial dysfunction, as well as instrumental methods (ECG, echocardiography, tissue Doppler imaging, renal artery Doppler imaging). Results. It was found that patients with IHD and T2DM had more pronounced lipid and carbohydrate metabolism disorders: increased triglyceride levels, decreased HDL cholesterol, increased HbA1c, and increased platelet aggregation activity. These changes were accompanied by worse endothelial function and a higher Gensini score, indicating severe coronary artery disease. Lipid and carbohydrate metabolism disorders were significantly associated with the development of endothelial dysfunction and renal disorders, increasing residual cardiovascular risk. Conclusion. Lipid and carbohydrate disorders are key components of residual risk in patients with IHD after myocardial revascularization. The identification of these disorders should be taken into account when developing personalized secondary prevention strategies.