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糖尿病患者经皮冠状动脉介入治疗或急性冠状动脉综合征后的二级预防疗法。

Secondary prevention therapies following percutaneous coronary intervention or acute coronary syndrome in patients with diabetes mellitus.

作者信息

Planchat Arnaud, Gencer Baris, Degrauwe Sophie, Musayeb Yazan, Roffi Marco, Iglesias Juan F

机构信息

Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland.

Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.

出版信息

Front Cardiovasc Med. 2024 Nov 22;11:1436332. doi: 10.3389/fcvm.2024.1436332. eCollection 2024.

Abstract

Diabetes mellitus (DM) promotes atherosclerosis, leading to increased risk for cardiovascular morbidity and mortality. Diabetics represent a challenging subset of patients undergoing percutaneous coronary intervention (PCI) or who have experienced an acute coronary syndrome (ACS), a subset characterized by higher rates of recurrent ischemic events compared with non-diabetics. These events are caused by both patient-related accelerated atherosclerotic disease progression and worse stent-related adverse clinical outcomes translating into a higher risk for repeat revascularization. In addition, DM is paradoxically associated with an increased risk of major bleeding following PCI or an ACS. Secondary prevention therapies following PCI or an ACS in diabetic patients are therefore of paramount importance. This mini review focuses on the currently available evidence regarding short- and long-term secondary prevention treatments for diabetic patients undergoing PCI or who have experienced an ACS.

摘要

糖尿病(DM)会促进动脉粥样硬化,导致心血管疾病发病率和死亡率增加。糖尿病患者是接受经皮冠状动脉介入治疗(PCI)或经历过急性冠状动脉综合征(ACS)的具有挑战性的患者亚组,与非糖尿病患者相比,该亚组的复发性缺血事件发生率更高。这些事件是由患者相关的加速动脉粥样硬化疾病进展以及更差的支架相关不良临床结局导致的,这转化为更高的重复血运重建风险。此外,矛盾的是,DM与PCI或ACS后大出血风险增加有关。因此,糖尿病患者PCI或ACS后的二级预防治疗至关重要。本综述聚焦于目前关于接受PCI或经历ACS的糖尿病患者短期和长期二级预防治疗的现有证据。

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