Aronson Doron, Edelman Elazer R
Department of Cardiology, Rambam Medical Center, Technion, Israel Institute of Technology, P.O.B 9602, Haifa 31096, Israel.
Cardiovascular Division, Department of Medicine, Institute for Medical Science and Engineering, Massachusetts Institute of Technology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Heart Fail Clin. 2016 Jan;12(1):117-33. doi: 10.1016/j.hfc.2015.08.010.
Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM.
糖尿病(DM)是心血管疾病的主要危险因素。接近正常的血糖控制并不能减少心血管事件。对于许多患有单支或双支冠状动脉疾病的患者,与最佳药物治疗相比,任何血运重建手术几乎没有益处。对于多支冠状动脉疾病,随机试验表明,在接受治疗的糖尿病患者中,冠状动脉搭桥术优于多支经皮冠状动脉介入治疗。然而,选择最佳的心肌血运重建策略需要多学科团队方法(“心脏团队”)。本综述总结了关于各种药物治疗和血运重建策略对糖尿病患者有效性的当前证据。