Antithrombotic therapy after X-ray endovascular treatment: Are there specific features in patients with diabetes mellitus?


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Abstract

According to the current guidelines for the intervention treatment of patients with coronary heart disease, the primary and secondary prevention of cardiovascular events is long-term pharmacotherapy with platelet function inhibitors. Although undeniable progress has been made in the use of this group of medicaments, there are, however, issues calling for further investigation in the population of diabetic patients in particular. Along with the general principles of thrombosis, there are mechanisms that cause additional platelet hyperactivity in the presence of insulin deficiency and insulin resistance, metabolic and cellular disorders induced by hyperglycemia. The risk of resistance to standard antithrombotic therapy suggests a search for alternative ways to inhibit platelet aggregation, which is particularly relevant in diabetic patients.

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Антитромботическая терапия после рентгеноэндоваскулярного лечения: есть ли особенности у больных сахарным диабетом?. - Аннотация. Согласно современным рекомендациям по интервенционному лечению больных ишемической болезнью сердца первичной и вторичной профилактикой сердечно-сосудистых осложнений является длительная фармакотерапия лекарственными средствами, ингибирующими функцию тромбоцитов. Однако на фоне несомненного успеха применения данной группы препаратов остаются вопросы, требующие дальнейшего изучения, особенно в популяции больных сахарным диабетом (СД). Наряду с общими принципами тромбообразования существуют механизмы, вызывающие дополнительное гиперактивное состояние тромбоцитов в условиях дефицита инсулина и инсулинорезистентности, метаболических и клеточных нарушений, вызванных гипергликемией. Вероятность развития резистентности к стандартной антитромботической терапии предполагает поиск альтернативных путей ингибирования агрегации тромбоцитов, что особенно актуально для пациентов с СД.
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