therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-81563033-8344РостГМУ10.21886/2712-8156-2022-3-4-7-24therapeutic-313Research ArticleОБЗОРЫREVIEWSСахарный диабет 2 типа и микрососудистые осложнения у больных стабильной ишемической болезнью сердца: распространенность, прогноз и выбор антитромботической терапииType two diabetes mellitus and microvascular complications in patients with coronary artery disease: prevalence, prognosis and choice of antithrombotic therapyКозиоловаН. А.KoziolovaN. A.

Козиолова Наталья Андреевна, д.м.н., профессор, заведующая кафедрой пропедевтики внутренних болезней №2

Пермь

Natalya A. Koziolova, Dr. Sci. (Med.), professor, head of the Department of Propaedeutic of Internal Diseases №2

Perm

nakoziolova@mail.ruПолянскаяЕ. А.PolyanskayaE. A.

Полянская Елена Александровна, доцент кафедры пропедевтики внутренних болезней №2

Пермь

Elena A. Polyanskaya, assistant professor of the Department of Propaedeutic of Internal Diseases №2

Perm

eapolyanskaya@gmail.comМироноваС. В.MironovaS. V.

Миронова Снежана Владимировна, ассистент кафедры пропедевтики внутренних болезней №2

Пермь

Elena A. Polyanskaya, assistant professor of the Department of Propaedeutic of Internal Diseases №2

Perm

sv.mironova.2017@yandex.ruФГБОУ ВО «Пермский государственный медицинский университет имени академика Е.А. Вагнера» Минздрава РоссииРоссияE.A. Wagner Perm State Medical UniversityRussian Federation20223012202234724Copyright © Козиолова Н.А., Полянская Е.А., Миронова С.В., 20222022Козиолова Н.А., Полянская Е.А., Миронова С.В.Koziolova N.A., Polyanskaya E.A., Mironova S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/313

В обзоре представлена информация о распространённости как сахарного диабета 2 типа (СД 2 типа) и его микрососудистых осложнений среди больных ишемической болезнью сердца (ИБС), так и ИБС среди больных с нарушениями углеводного обмена. Показано, что прогноз больных ИБС и СД 2 типа, особенно при наличии микрососудистых осложнений, крайне неблагоприятен, и характеризуется значительным увеличением риска сердечно-сосудистой смерти, инфаркта миокарда, инсульта, терминальной хронической болезни почек и нарушениями зрения. Отмечено, что, несмотря на успехи, достигнутые в лечении ИБС, СД 2 типа и его микрососудистых осложнений, сохраняется высокий риск общей сердечно-сосудистой смерти и госпитализаций, связанных с сердечно-сосудистыми заболеваниями. При СД 2 типа, особенно при наличии микрососудистых осложнений и коморбидной патологии, выделены особые патогенетические механизмы тромботического риска и кровотечений. На основании проведённых больших рандомизированных клинических исследований в обзоре оценена эффективность и безопасность различных антитромботических стратегий у больных стабильной ИБС, СД 2 типа при наличии микроваскулярных осложнений и коморбидной патологии.

The review presents the prevalence of both type 2 diabetes mellitus (type 2 DM) and its microvascular complications among patients with coronary heart disease (CHD), and CHD among patients with carbohydrate metabolism disorders. It is shown, that the prognosis of patients with CHD and type 2 DM, especially in the presence of microvascular complications, is extremely unfavorable, and is characterized by a significant increase in the risk of cardiovascular death, myocardial infarction, stroke, terminal stage of the chronic kidney disease and visual impairment. It was noted, that despite the successes achieved in the treatment of CHD, type 2 DM and its microvascular complications, there is a high risk of total, cardiovascular mortality and hospitalizations associated with cardiovascular diseases. In type 2 DM, especially in the presence of microvascular complications and comorbid pathology, special pathogenetic mechanisms of thrombotic risk and bleeding have been identified. Based on large randomized clinical trials, the review evaluated the efficacy and safety of various antithrombotic strategies in patients with stable СРВ, type 2 DM in the presence of microvascular complications and comorbid pathology.

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The authors declare that there are no conflicts of interest present.