Leschke M, Schwenk B, Bollinger C, Faehling M
Klinik für Kardiologie, Pneumologie und Angiologie, Arztlicher Direktor, Städtische Kliniken Esslingen, Hirschlandstr. 97, 73730 Esslingen, Germany.
Clin Res Cardiol. 2006 Jan;95 Suppl 1:i98-102. doi: 10.1007/s00392-006-1118-8.
Patients with ischaemic heart disease commonly have an impaired glucose tolerance. On the 2004 congress of the ESC, the 75-75-rule was announced, indicating that 75% of all diabetics die of cardiovascular complications, and that 75% of all patients with myocardial infarction have diabetes or an (often undiagnosed) impaired glucose tolerance. Data of our "Esslinger Koronarregister" confirm that diabetics and in particular women with diabetes have a higher mortality both after STEMI and NSTEMI. During acute myocardial infarction, a higher blood glucose level strongly correlates with increased mortality. This increased blood glucose level on the one hand is due to preexisting diabetes mellitus or metabolic syndrome, but on the other hand may be a marker of larger myocardial damage with excess katecholamine release. Recent data indicate that intensive glucose control results in a reduction of cardiovascular risk, e. g. the risk of sudden cardiac death. The data presented show that an early intervention in preclinical diabetics aiming at normalization of blood glucose control is necessary in order to reduce cardiovascular mortality.
缺血性心脏病患者通常存在糖耐量受损。在2004年欧洲心脏病学会大会上，宣布了75 - 75规则，即75%的糖尿病患者死于心血管并发症，75%的心肌梗死患者患有糖尿病或（通常未被诊断出的）糖耐量受损。我们“埃斯林根冠状动脉登记处”的数据证实，糖尿病患者，尤其是女性糖尿病患者，在ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）后死亡率更高。在急性心肌梗死期间，较高的血糖水平与死亡率增加密切相关。这种血糖水平升高一方面是由于既往存在的糖尿病或代谢综合征，但另一方面可能是较大心肌损伤伴儿茶酚胺过量释放的一个标志。近期数据表明，强化血糖控制可降低心血管风险，例如心源性猝死风险。所呈现的数据表明，为降低心血管死亡率，对临床前期糖尿病患者进行早期干预以实现血糖控制正常化是必要的。
