[INFLUENCE OF THE METFORMIN THERAPY ON THE ACTIVITY OF ENDOTHELIAL-DEPENDENT MEDIATORS AMONG PATIENTS WITH ACUTE...

Aim of study‒ estimate the influence of the metformin therapy on the sCD40-ligand and sVE-cadherinlevels among patients with acute myocardial infarction and concomitant type 2 diabetes mellitus. The study included44patients with AMI and type 2 diabetes whichweredividedintotwo groupsdependingonthe glucose lowering drugs they have been taken: I group ‒ 21patients who have been taken metformin; II group ‒ 23patients, who have been taken short-acting insulin. Accordingtotheobtainedresults using of metformin as a glucose lowering drug in comparison with patients who have been taken short-acting insulin causes faster decreasing of the sCD40L level (-29,3% and -24,4% accordingly; р<0,05). Whereas there was no significant differencesin the dynamics of sVE-cadherinlevels (-22,4% and -19,2% accordingly; р>0,05). Positive influence of them et form in on thes CD40-ligand level probably is caused by the inhibition of the Akt-kinase phosphorylation responsible for the activation of the nuclear factor kappa-b which controls expression of the immune response genes, particulary CD40. It leads to the inhibition of the thrombocytes activation and differentiation of the monocytes to the macrophages able to product proatherogenic factors. It was established that metformin therapy among patients with acute myocardial infarction and diabetes mellitus type 2 leads to the faster decreasing of sCD40-ligand in comparison with insulin therapy, which can contribute to the improvemenet of the prognosis in this cohort.