Статья
ПАЦИЕНТ С САХАРНЫМ ДИАБЕТОМ И РЕВАСКУЛЯРИЗАЦИЯ МИОКАРДА С ПОЗИЦИЙ ДОКАЗАТЕЛЬНОЙ МЕДИЦИНЫ: ВЗГЛЯД КАРДИОЛОГА. ЧАСТЬ 2
В обзоре проведен анализ современного состояния проблемы периоперационного назначения сахароснижающих препаратов у пациентов с сахарным диабетом при реваскуляризации миокарда. Представлены позиции текущих клинических рекомендаций основных сообществ по изучению диабета и сердечно-сосудистых заболеваний по данному вопросу, и освещены те его аспекты, в которых на данный момент недостаточно доказательной базы. Приведены результаты исследований, сравнивающих различные стратегии ведения данной категории пациентов. Показана значимость компенсации углеводного обмена при реваскуляризации миокарда, при этом подтвержден тот факт, что излишне строгий контроль гликемии не имеет преимущества ни при чрескожном, ни при открытом коронарном вмешательстве. Описаны основные группы сахароснижающих препаратов в аспекте их влияния сердечно-сосудистую систему в соответствии с данными завершившихся испытаний. Обоснована важность комплексного контроля основных факторов риска у пациентов с диабетом при коронарном вмешательстве.
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