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糖尿病与非心脏动脉粥样硬化性血管疾病——发病机制和药理学治疗选择。

Diabetes Mellitus and Noncardiac Atherosclerotic Vascular Disease-Pathogenesis and Pharmacological Treatment Options.

机构信息

Department of Internal Medicine, Endocrinology Section, 274294Clinical Centre of Montenegro, Ljubljanska bb, Podgorica, Montenegro.

Faculty of Medicine, University of Montenegro, Kruševac bb, Podgorica, Montenegro.

出版信息

J Cardiovasc Pharmacol Ther. 2021 Jan;26(1):25-39. doi: 10.1177/1074248420941675. Epub 2020 Jul 15.

Abstract

Diabetes mellitus (DM) is also a cause of cardiovascular (CV) disease (CVD). Addressing the atherosclerotic CVD (ASCVD) burden in DM should reduce premature death and improve quality of life. Diabetes mellitus-associated ASCVD can lead to complications in all vascular beds (carotids as well as coronary, lower extremity, and renal arteries). This narrative review considers the diagnosis and pharmacological treatment of noncardiac atherosclerotic vascular disease (mainly in patients with DM). Based on current knowledge and the fact that modern DM treatment guidelines are based on CV outcome trials, it should be noted that patients with noncardiac CVD may not have the same benefits from certain drugs compared with patients who predominantly have cardiac complications. This leads to the conclusion that in the future, consideration should be given to conducting well-designed trials that will answer which pharmacological treatment modalities will be of greatest benefit to patients with noncardiac ASCVD.

摘要

糖尿病(DM)也是心血管疾病(CVD)的一个病因。解决糖尿病患者的动脉粥样硬化性心血管疾病(ASCVD)负担,应该可以降低早逝风险,提高生活质量。与糖尿病相关的 ASCVD 可导致所有血管床(颈动脉以及冠状动脉、下肢和肾动脉)发生并发症。本综述讨论了非心脏动脉粥样硬化性血管疾病(主要是在糖尿病患者中)的诊断和药物治疗。基于现有知识,以及现代糖尿病治疗指南基于心血管结局试验这一事实,应当注意到,与主要患有心脏并发症的患者相比,患有非心脏 CVD 的患者可能无法从某些药物中获得相同的益处。这得出的结论是,未来应考虑进行精心设计的试验,以解答哪些药物治疗方式对非心脏 ASCVD 患者最有益。

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