diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM8031diaendo-8031Research ArticleКардиологияCardiologyРеваскуляризация миокарда у больных ИБС в сочетании с сахарным диабетом 2 типа: обзор современных технологийMyocardial revascularization in patients with type 2 diabetes mellitus: An overview of modern techniquesГолуховаЕлена ЗеликовнаGolukhovaElena Zelikovnaegolukhova@yahoo.comКузнецоваЕлена ВладиславовнаKuznetsovaElena Vladislavovnaelena-v-kuznetsova@rambler.ruФГБУ Научный центр сердечно-сосудистой хирургии им. А.Н. Бакулева Минздрава РоссииРоссияBakoulev Scientific Center for cardiovascular SurgeryRussian Federation201631122016195406413Copyright © Голухова Е.З., Кузнецова Е.В., 20162016Голухова Е.З., Кузнецова Е.В.Golukhova E.Z., Kuznetsova E.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.dia-endojournals.ru/jour/article/view/8031

Для больных ишемической болезнью сердца (ИБС) в сочетании с сахарным диабетом 2 типа (СД2) характерно многососудистое, диффузное поражение коронарного русла. Эта группа пациентов подвержена более быстрому прогрессированию атеросклероза, что значительно повышает потребность в проведении реваскуляризации миокарда. Выбор оптимального подхода определяет улучшение прогноза и течения ИБС. Анализ результатов рандомизированных исследований показывает, что использование чрескожных коронарных вмешательств с применением стентов с лекарственным покрытием приемлемо, если речь идет об одно- или двухсосудистом поражении коронарного русла. При многососудистом поражении предпочтительно выполнение операции аорто-коронарного шунтирования, что значительно снижает риски неблагоприятных событий в отдаленном периоде. Отметим также, что использование современных поколений стентов позволяет добиваться сопоставимых результатов по показателям отдаленной летальности, что наиболее убедительно продемонстрировано у пациентов с одно- и двух-сосудистым поражением.

For patients with coronary artery disease (CAD), in combination with diabetes mellitus, diffuse multivessel coronary artery lesions are common. Such patients are prone to a more rapid progression of atherosclerosis, significantly increasing the need for myocardial revascularization. The choice of an optimal approach determines the prognosis and course of CAD. The results of randomized trials show that the use of percutaneous coronary interventions with drug-eluting stents is appropriate for patients with one or two coronary artery lesions, but that coronary artery bypass graft surgery is preferred in cases of multivessel disease and significantly reduces the risk of long-term adverse events. It should also be noted that the use of modern generations of stents allows the achievement of comparable results in terms of long-term mortality, which was most convincingly demonstrated in patients with one or two vascular lesions.

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