russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2017-4-105-113russjcardiol-876Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWПАЦИЕНТ С САХАРНЫМ ДИАБЕТОМ И РЕВАСКУЛЯРИЗАЦИЯ МИОКАРДА С ПОЗИЦИЙ ДОКАЗАТЕЛЬНОЙ МЕДИЦИНЫ: ВЗГЛЯД КАРДИОЛОГА. ЧАСТЬ 1PATIENTS WITH DIABETES AND MYOCARDIAL REVASCULARIZATION FROM EVIDENCE-BASED MEDICINE POSITIONS: CARDIOLOGIST’S OPINION. PART 1https://orcid.org/0000-0002-9396-4575БезденежныхН. А.BezdenezhnykhN. A.

Безденежных Наталья Александровна - к. м.н., н. с. лаборатории патологии кровообращения

Bezdenezhnykh Natalia Alexandrovna - Candidate of Medical Sciences, Researcher, Laboratory of circulation pathology

n_bez@mail.ruСуминА. Н.SuminA. N.

Сумин Алексей Николаевич - д.м.н., заведующий отделом мультифокального атеросклероза

Sumin Alexei Nikolaevich -  Doctor of Medical Sciences, Chief of Department of multifocal atherosclerosis

an_sumin@mail.ruБарбарашО Л.BarbarashO. L.

Барбараш Ольга Леонидовна - д.м.н., член-корр. РАН, заведующая кафедрой кардиологии и сердечно-сосудистой хирургии КемГМУ,  директор НИИ КПССЗ.

Barbarash Olga Leonidovna -  Doctor of Medical Sciences, Corresponding Member of the Russian Academy of Sciences, Head of Department of Cardiology and Cardiovascular Surgery, Director of the Research Institute for Complex Issues of Cardiovascular Diseases

olb61@mail.ruФГБНУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian FederationФГБНУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний; ГБОУ ВО Кемеровский государственный медицинский университетРоссияResearch Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State UniversityRussian Federation20170705201704105113Copyright © Безденежных Н.А., Сумин А.Н., Барбараш О.Л., 20172017Безденежных Н.А., Сумин А.Н., Барбараш О.Л.Bezdenezhnykh N.A., Sumin A.N., Barbarash O.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/876

В обзоре приведены современные данные по распространенности сахарного диабета в когортах пациентов, подвергающихся коронарному шунтированию и чрескожному коронарному вмешательству. Показана целесообразность активного подхода к выявлению диабета и предиабета у пациентов с ишемической болезнью сердца перед коронарной реваскуляризацией. Представлена актуальная информация о негативном влиянии сахарного диабета на прогноз реваскуляризации миокарда, и освещены основные механизмы, ответственные за развитие неблагоприятных исходов вмешательства у данной категории больных. Сопоставлены целевые периоперационные значения гликемии, рекомендованные ведущими сообществами по изучению диабета, и показана роль других маркеров углеводного обмена (гликированный гемоглобин, фруктозамин, 1,5-ангидроглюцитол) у пациентов с сахарным диабетом в аспекте их вклада в сердечно-сосудистый прогноз, в том числе при коронарных вмешательствах.

The review presents current data on the prevalence of diabetes in the cohort of patients undergoing coronary artery bypass grafting and percutaneous coronary intervention. The expediency of a proactive approach to identifying diabetes and pre-diabetes in patients with coronary heart disease before coronary revascularization is reviewed. The current information about the negative impact of diabetes on the prognosis of myocardial revascularization is provided, and the main mechanisms responsible for the development of adverse outcomes of interventions in these patients are highlighted. Target values of perioperative glycemia recommended by the leading communities of the study of diabetes are compared, and shown the role of other carbohydrate metabolism markers (glycated hemoglobin, fructosamine, 1,5-anhydroglucitol) in patients with diabetes mellitus in terms of their impact on cardiovascular prognosis, including with coronary intervention.

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