Cardiovascular-kidney-metabolic syndrome in patients with acute forms of ischemic heart disease

Olga Koroliuk; Olena Radchenko; Marta Kondratyuk; Serhii Stadnik

Olga Koroliuk Department of Internal Medicine No. 2, State Non-Profit Enterprise Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Olena Radchenko Department of Internal Medicine No. 2, State Non-Profit Enterprise Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Marta Kondratyuk Department of Internal Medicine No. 2, State Non-Profit Enterprise Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Serhii Stadnik Department of Internal Medicine No. 2, State Non-Profit Enterprise Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

Keywords: cardiovascular-kidney-metabolic syndrome, creatinine, proteinuria, glomerular filtration rate, heart structure

Abstract

The purpose of the study was to evaluate the cardiac and renal manifestations of cardiovascular-kidney-metabolic syndrome (CKMs) in patients of different glucometabolic categories. A total of 116 patients with ischaemic heart disease (IHD) and acute coronary syndrome aged 37 to 84 years were examined. Based on their carbohydrate metabolism status, they were divided into 5 groups: 24 patients with normal glucose regulation (NGR); 23 – with impaired fasting glycaemia (IFG); 21 – with impaired glucose tolerance (IGT); 24 – with a combination of IFG and IGT; 24 – with type 2 diabetes mellitus (DM). The patients underwent an oral glucose tolerance test, creatinine levels were determined by colorimetry, proteinuria was determined, and glomerular filtration rate (GFR) was calculated using the MDRD formula. In patients with acute forms of IHD, as carbohydrate metabolism deviated from NGR through IFG, IGT and combined prediabetic disorders leading to type 2 DM, a gradual stretching of the left heart chambers and an increase in their myocardial mass and indexed value were observed without affecting systolic function. At the same time, proteinuria and blood creatinine increased and GFR decreased, which may be manifestations of CKMs. Proteinuria directly correlated with total fibrinogen levels, and creatinine correlated with glucose at the end of the glucose tolerance test. Patients with acute forms of IHD may be diagnosed with CKMs, which manifests itself in gradual stretching of the left heart chambers and an increase in myocardial mass, increased proteinuria and blood creatinine with a decrease in GFR as carbohydrate metabolism deteriorates.