Myocardial revascularization in diabetic patients presenting with critical limbischemia
Abstract
The frequency of diabetic complications remains high despite the development of improved therapeutic modalities. Macroangiopathy continues to bethe predominant complication while coronary heart disease is the main cause of mortality.This paper considers clinical features of diabetic patientswith coronary heart disease and critical limb ischemia; various aspects of optimal drug therapy, preoperative examination and diagnostics precedingvascular non-cardiac surgery; preoperative risk assessment; indications for coronary angiography and myocardial revascularization. The authors emphasizethe importance of development of algorithms for the treatment of patients with diabetes, critical limb ischemia, and coronary heart disease.
About the Authors
Ivan Ivanovich Dedov
Endocrinology Research Centre, Moscow
Victor Yur'evich Kalashnikov
Endocrinology Research Centre, Moscow
Konstantin Vladimirovich Melkozerov
Endocrinology Research Centre, Moscow
References
1. Buse J.B., Ginsberg H.N., Bakris G.L. et al. Primary Prevention of Cardiovascular Diseases in People With Diabetes Mellitus. A Scientific Statement From the American Heart Association and the American Diabetes Association // Circulation. - 2007. - Vol. 2. - P. 114-126.
2. Cortigiani L., Bigi R., Sicari R. et al. Prognostic Value of Pharmacological Stress Echocardiography in Diabetic and Nondiabetic Patients With Known or Suspected Coronary Artery Disease // J. Am. Coll. Cardiol. - 2006. - Vol. 47. - P. 605-610.
3. Young L.H., Wackers F.J.Th., Chyun D.A. et al. Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes: The DIAD Study: A Randomized Controlled Trial // JAMA. - 2009. - Vol. 301(15). - P. 1547-1555.
4. Weckbach S., Findeisen H.M., Schoenberg S.O., Kramer H., Stark R., Clevert D.A., Reiser M.F., Parhofer K.G. Systemic cardiovascular complications in patients with long-standing diabetes mellitus: comprehensive assessment with whole-body magnetic resonance imaging/magnetic resonance angiography. - 2009. - Vol. 44(4). - P. 242-250.
5. Sex Differences in the Effect of Diabetes Duration on Coronary Heart Disease Mortality // Arch. Intern. Med. - 2005. - Vol. 165. - P. 430-435.
6. Abramson B.L., Huckell V., Anand S., et al. Canadian cardiovascular society Consensus Conference: Peripheral arterial disease - executive summary // Can. J. Cardiol. - 2005. - Vol. 21 (12). - P. 997-1006.
7. Dormandy J.A., Rutherford R.B. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC) // J Vasc Surg. - 2000. - Vol. 31(1 Pt2). - S1-S296.
8. Norgren L., Hiatt W.R., Dormandy J.A., et al. Inter-society consensus for the management of peripheral arterial disease (TASC II) // J. Vasc. Surg. - 2007. - Vol. 45(1 Suppl). - P. S5-S7.
9. Critical limb ischemia. A publication of national healing corporation. Доступно: ttp://www.nationalhealing.comdownloadsnhcwhpspring06.pdf.
10. McFalls E.O., Ward H.B., Moritz T.E., Goldman S., Krupski W.C., Littooy F., Pierpont G., Santilli S., Rapp J., Hattler B., Shunk K., Jaenicke C., Thottapurathu L., Ellis N., Reda D.J., Henderson W.G. Coronary-artery revascularization before elective major vascular surgery // N. Engl. J. Med. - 2004. - Vol. 351. - P. 2795-2804.
11. Steg P.G., Bhatt D.L., Wilson P.W.F., et al; REACH Registry Investigators. One-year cardiovascular event rates in outpatients with atherothrombosis // JAMA. - 2007. - Vol. 297(11). - P. 1197-1206.
12. Grundy S.M., Cleeman J.I., Merz C.N.B., et al; Coordinating Committee of the National Cholesterol Education Program. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines [published correction appears in Circulation. - 2004;110(6):763] // Circulation. 2004. - Vol. 110(2) . - P. 227-239.
13. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases до- ступно: http://www.escardio.org/guidelines-surveys/escguidelines/ GuidelinesDocuments/guidelines-diabetes-FT.pdf.
14. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction and stroke in high risk patients // BMJ. - 2002. - Vol. 324. - P. 71-85.
15. Hirsch A.T., Haskal Z.J., Hertzer N.R., et al. ACC/AHA 2005 Practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation // Circulation. - 2006. - Vol. 113(11). - P. e463-e654.
16. Yusuf S., Sleight P., Pogue J., Bosch J., Davies R., Dagenais G. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin- converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. [published corrections appear in N Engl J Med. - 2000; 342 (18): 1376 and 2000;342(10):748] // N. Engl. J Med. 2000. - Vol. 342(3). - P. 145-153.
17. Ahimastos A.A., Lawler A., Reid C.M., Blombery P.A., Kingwell B.A. Brief communication: ramipril markedly improves walking ability in patients with peripheral arterial disease: a randomized trial // Ann. Intern. Med. - 2006. - Vol. 144(9). - P. 660-664.
18. Radack K., Deck C. -adrenergic blocker therapy does not worsen intermittent claudication in subjects with peripheral arterial disease: a metaanalysis of randomized controlled trials // Arch Intern Med. - 1991. - Vol. 151(9). - P. 1769-1776.
19. Guidelines on myocardial revascularization доступно: http://www.escardio. org/guidelines-surveys/esc-guidelines/Guidelines Documents/guidelines- revasc-FT.pdf.
20. Документы второго Европейского консенсуса по хронической критической ишемии нижних конечностей. доступно: http://www.rusmedserv. com/vassurg/konc.htm.
21. Бунина М.В., Головенко Е.Н., Лабутина Ю.О., Самойленко В.В., Силаев Б.В., Фадеев В.В. Предоперационный период. -М.: - Гэотар- Медиа, 2009.
22. Данилов М., Матчин Ю.Г., Горгадзе Т.Т., Чазова И.Е., Савченко А.П. Показания к проведению коронарной артериографии // Consilium medicum. - 2006. - Т. 1(1).
23. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention. A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention)// J. Am. Coll. Cardiol. - 2006. - Vol. 47. - P. 1-121.
24. focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. - 2008. - Vol. 51. - P. 172-209.
25. Timmer J.R, Ottervanger J.P., Thomas K., J Hoorntje. C.A, de Boer M.-J., Suryapranata H., F.Zijlstra. Long-term, cause-specific mortality after myocardial infarction in diabetes // Eur. Heart. J. - 2004. - 2; 25(11). - P. 926-931.doi: 10.1016/j.ehj.2004.04.001.
26. Диагностика и лечение больных острым инфарктом миокарда с подъемом сегмента ST электрокардиограммы. Российские рекомендации. Разработаны Комитетом экспертов Всероссийского научного обще- ства кардиологов. - М., 2007. - 36с.
27. Fox K.A., Clayton T.C., Damman P. et al. Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data // J. Am. Coll. Cardiol. - 2010. - Vol. 55(22). - P. 2435-2445.
28. BARI 2D Study Group. A randomized trial of therapies for type 2 diabetes and coronary artery disease // N. Engl. J. Med. - 2009. - Vol. 360(24). - P. 2503-2515.
29. Trikalinos T.A., Alsheikh-Ali A.A., Tatsioni A. et al. Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis // Lancet. - 2009. - Vol. 373. - P. 911-918.
30. Corpus R.A., George P.B., House J.A., et al. Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II diabetic patients undergoing elective percutaneous coronary intervention // J. Am. Coll. Cardiol. - 2004. - Vol. 43(1). - P. 8-14.
31. Poldermans D., Schouten O., Vidakovic R., Bax J.J., Thomson I.R., Hoeks S.E., Feringa H.H., Dunkelgrun M., de Jaegere P., Maat A., van Sambeek M.R., Kertai M.D., Boersma E. A clinical randomized trial to evaluate the safety of a noninvasive approach in high-risk patients undergoing major vascular surgery: the DECREASE-V Pilot Study // J. Am. Coll. Cardiol. - 2007. - Vol. 49. - P. 1763-1769.
32. Monaco M., Stassano P., Di Tommaso L., Pepino P., Giordano A., Pinna G.B., Iannelli G., Ambrosio G. Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study // J. Am. Coll. Cardiol. - 2009. - Vol. 54. - P. 989-996.
33. Saleem T., Hameedullah K.M., Moataz M Abdel-Fattah and Abdul Hafeez Abbasi. Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease // Diab. Vasc. Dis. Res. - 2008. - Vol. 5. - P. 184.
34. Tonino P.A.L., De Bruyne B., Pijls N.H.J. et al. Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention // N. Engl. J. Med. - 2009. - Vol. 360. - P. 213-224.
Review
For citations:
Dedov I.I., Kalashnikov V.Yu., Melkozerov K.V. Myocardial revascularization in diabetic patients presenting with critical limbischemia. Diabetes mellitus. 2010;13(4):25-29. (In Russ.)
Views:
724
Email this article 
