Cardiology Unit, Department of Medicine Solna, Karolinska Institute Heart & Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
EuroIntervention. 2021 Oct 1;17(8):e618-e630. doi: 10.4244/EIJ-D-20-01250.
The number of individuals with diabetes and pre-diabetes is constantly increasing. These conditions are overrepresented in patients undergoing percutaneous coronary intervention and are associated with adverse prognosis. Optimal glycaemic control during an acute coronary syndrome is a relevant factor for the improvement of longer-term outcomes. In addition, the implementation of newer glucose-lowering drugs with proven cardiovascular benefits has a remarkable impact on recurrence of events, hospitalisations for heart failure and mortality. In this narrative review, we outline the current state-of-the art recommendations for glucose-lowering therapy in patients with diabetes undergoing coronary intervention. In addition, we discuss the most recent evidence-based indications for revascularisation in patients with diabetes as well as the targets for glycaemic control post revascularisation. Current treatment goals for concomitant risk factor control are also addressed. Lastly, we acknowledge the presence of knowledge gaps in need of future research.
糖尿病和糖尿病前期患者的数量不断增加。这些病症在接受经皮冠状动脉介入治疗的患者中更为常见，与不良预后相关。急性冠状动脉综合征期间的最佳血糖控制是改善长期预后的一个相关因素。此外，使用具有明确心血管益处的新型降糖药物对事件复发、心力衰竭住院和死亡率有显著影响。在这篇叙述性综述中，我们概述了接受冠状动脉介入治疗的糖尿病患者的降糖治疗的最新推荐。此外，我们还讨论了糖尿病患者血管重建的最新循证适应证以及血管重建后的血糖控制目标。还讨论了针对并存危险因素控制的当前治疗目标。最后，我们承认存在需要进一步研究的知识空白。
