diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/2072-0351-95diaendo-95Research ArticleКардиологияCardiologyМеханизмы тромбообразования, ассоциированные с сахарным диабетом: что определяет прогноз интервенционного вмешательства?Mechanisms of thrombogenesis associated with diabetes mellitus: what defines the prognosis of invasive myocardial revascularization methods?БондаренкоИрина ЗиятовнаBondarenkoIrina Ziyatovna

д.м.н., гл.н.с. отделения интервенционной кардиологии

MD, PhD, Chief Scientist at the Department of Interventional Cardiology

ia86@mail.ruШиршинаИрина АлександровнаShirshinaIrina Alexandrovna

- аспирант отделения интервенционной кардиологии

graduate student at the Department of Interventional Cardiology

ia86@mail.ruФГБУ Эндокринологический научный центр Минздрава РФРоссияEndocrinology Research Centre, MoscowRussian Federation201305112013163Сахарный диабет5863Copyright © Бондаренко И.З., Ширшина И.А., 20132013Бондаренко И.З., Ширшина И.А.Bondarenko I.Z., Shirshina I.A.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/95

В настоящее время инвазивные методы реваскуляризации миокарда прочно заняли лидирующие позиции в лечении ишемической болезни сердца (ИБС). Но все достижения эндоваскулярного лечения не были бы столь эффективны и безопасны без применения дезагрегантов, являющихся обязательным медикаментозным сопровождением эндоваскулярного вмешательства. Эффективность антитромботической терапии у пациентов с сахарным диабетом (СД) снижена по сравнению с общей популяцией, что влияет на прогноз чрескожного вмешательства (ЧКВ). По-видимому, это связано с тем, что при СД имеются свои особенности клеточного гемостаза, зависящие от степени и длительности декомпенсации углеводного обмена. В данной статье рассматриваются факторы, влияющие на механизмы тромбообразования у пациентов с СД

Cardiovascular intervention for myocardial revascularization dominates modern treatment of ischaemic heart disease (IHD). Current efficiency and safety of this method could never be achieved without the development of antiplatelet agents that provide indispensable protection for endovascular interventions. However, antithrombotic therapy is generally less effective in diabetes mellitus (DM), affecting prognosis for transcutaneous intervention. This trend is probably due to alteration of cellular homeostasis during hyperglycemia and correlates with its severity and persistence. This paper addresses modern understanding of factors affecting thrombogenesis in patients with DM.

сахарный диабетгемостазишемическая болезнь сердцафункции тромбоцитовdiabetes mellitushaemostasisischaemic heart diseaseplatelet functionsReferencesStratman B, Tschoehe D. Pathobiology and cell interactions of platelets in diabetes. Diab Vasc Dis Res. 2005;2:16-23Stratman B, Tschoehe D. Pathobiology and cell interactions of platelets in diabetes. Diab Vasc Dis Res. 2005;2:16-23Stratman B, Tschoehe D. Pathobiology and cell interactions of platelets in diabetes. Diab Vasc Dis Res. 2005;2:16-23Stratman B, Tschoehe D. Pathobiology and cell interactions of platelets in diabetes. Diab Vasc Dis Res. 2005;2:16-23Winocour PD, Watala C, Perry DW, Kinlough-Rathbone R.L. Decreased platelet membrane fluidity due to glycation or acetylation of membrane proteins. Thromb Haemost. 1992;68:577-582Winocour PD, Watala C, Perry DW, Kinlough-Rathbone R.L. Decreased platelet membrane fluidity due to glycation or acetylation of membrane proteins. Thromb Haemost. 1992;68:577-582Keating FK, Sobel BE, Schneider DJ. Effects of increased concentrations of glucose on platelet reactivity in healthy subjects and in patients with and without diabetes mellitus. Am J Cardiol. 2003;92:1362-1365Keating FK, Sobel BE, Schneider DJ. Effects of increased concentrations of glucose on platelet reactivity in healthy subjects and in patients with and without diabetes mellitus. Am J Cardiol. 2003;92:1362-1365Tschoepe D, Roesen P, Kaufmann L, Schauseil S, Kehrel B, Ostermann H, Gries FA. Evidence for abnormal platelet glycoprotein expression in diabetes mellitus. Eur J Clin Invest, 1990;20:166-170Tschoepe D, Roesen P, Kaufmann L, Schauseil S, Kehrel B, Ostermann H, Gries FA. Evidence for abnormal platelet glycoprotein expression in diabetes mellitus. Eur J Clin Invest, 1990;20:166-170Guthikonda S, Alviar CL, Vaduganathan M, Tellez A, Delao T, Granada JF. Role of reticulated platelets and platelet size heterogeneity on platelet activity after dual antiplatelet therapy with aspirin and clopidogrel in patients with stable coronary artery disease. J Am Coll Cardiol. 2008;52:743-749Guthikonda S, Alviar CL, Vaduganathan M, Tellez A, Delao T, Granada JF. Role of reticulated platelets and platelet size heterogeneity on platelet activity after dual antiplatelet therapy with aspirin and clopidogrel in patients with stable coronary artery disease. J Am Coll Cardiol. 2008;52:743-749Randriamboavonjy V, Fleming I. Insulin, insulin resistance and platelet signaling in diabetes. Diabetes Care. 2009;32:528-530Randriamboavonjy V, Fleming I. Insulin, insulin resistance and platelet signaling in diabetes. Diabetes Care. 2009;32:528-530Hunter RW, Hers I. Insulin/IGF-1 hybrid receptor expression on human platelet: consequences for the effect of insulin on platelet function. J Thromb Haemost. 2009;7:2123-2130Hunter RW, Hers I. Insulin/IGF-1 hybrid receptor expression on human platelet: consequences for the effect of insulin on platelet function. J Thromb Haemost. 2009;7:2123-2130Ishida M, Ishida T, Ono N, Matsuura H, Watanade M, Kambe M, Oshima T. Effects of insulin on cakcium metabolism and platelet aggregation. Hypertension. 1996;28:209-212Ishida M, Ishida T, Ono N, Matsuura H, Watanade M, Kambe M, Oshima T. Effects of insulin on cakcium metabolism and platelet aggregation. Hypertension. 1996;28:209-212Randriamboavonjy V, Pistrosch F, Bolck B, Schwinger RH, Dixit M, Fleming I. Platelet sarcoplasmic endoplasmic reticulum Ca 2+ATPase and mu-calpain activity are altered in type 2 diabetes mellitus and restored by rosiglitazone. Circulation.2008;117:52-60Randriamboavonjy V, Pistrosch F, Bolck B, Schwinger RH, Dixit M, Fleming I. Platelet sarcoplasmic endoplasmic reticulum Ca 2+ATPase and mu-calpain activity are altered in type 2 diabetes mellitus and restored by rosiglitazone. Circulation.2008;117:52-60Sibbing D, von Beckerath O, Schomig A, Kastrati A. Impact of body mass index on platelet aggregation after administration of a high loading dose of 600 mg of clopidogrel before percutaneous coronary intervention. Am I Cardiol. 2007;100:203-205Sibbing D, von Beckerath O, Schomig A, Kastrati A. Impact of body mass index on platelet aggregation after administration of a high loading dose of 600 mg of clopidogrel before percutaneous coronary intervention. Am I Cardiol. 2007;100:203-205de Man FH, Nieuwland R, van der Laarse A, Romijn F, Smelt AH, Gevers Leuven J.A. Activated platelets in patients with severe hypertriglyceridemia: effects of triglyceride-lowering therapy. Atherosclerosis. 2000;152:407-414de Man FH, Nieuwland R, van der Laarse A, Romijn F, Smelt AH, Gevers Leuven J.A. Activated platelets in patients with severe hypertriglyceridemia: effects of triglyceride-lowering therapy. Atherosclerosis. 2000;152:407-414Belostocki K, Pricop L, Redecha PB, Aydin A, Leff L. Infliximab treatment shifts the balance between stimulatory and inhibitory Fcgamma receptor type II isoforms on neutrophils in patients with rheumatoid arthritis. Arthritis Rheum. 2008;58:384-388Belostocki K, Pricop L, Redecha PB, Aydin A, Leff L. Infliximab treatment shifts the balance between stimulatory and inhibitory Fcgamma receptor type II isoforms on neutrophils in patients with rheumatoid arthritis. Arthritis Rheum. 2008;58:384-388Stratmann B, Tschoehe D. Pathobiology and cell interactions of platelet in diabetes. Diab Vasc Dis Res. 2005;2: 16-23Stratmann B, Tschoehe D. Pathobiology and cell interactions of platelet in diabetes. Diab Vasc Dis Res. 2005;2: 16-23Creager MA, Luscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences and medical therapy: part I. Circulation.2003;108:1527-1532Creager MA, Luscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences and medical therapy: part I. Circulation.2003;108:1527-1532Boyden TF, Nallamothu BK, Moscucci M, Chan PS, Grossman PM, Tsai TT, Chetcuti SJ, Bates ER, Gurm HS. Meta-analysis of randomized trials of drug-eluting stents versus bare metal stents in patients with diabetes mellitus. Am J Cardiol. 2007 May 15;99(10):1399-402.Boyden TF, Nallamothu BK, Moscucci M, Chan PS, Grossman PM, Tsai TT, Chetcuti SJ, Bates ER, Gurm HS. Meta-analysis of randomized trials of drug-eluting stents versus bare metal stents in patients with diabetes mellitus. Am J Cardiol. 2007 May 15;99(10):1399-402.O'Donoghue, M.&Wiviott SD. Clopidogrel response variability and future therapies; clopidogrel: dose one size fit all? Circulation 114, e600-e606 (2006).O'Donoghue, M.&Wiviott SD. Clopidogrel response variability and future therapies; clopidogrel: dose one size fit all? Circulation 114, e600-e606 (2006).Marcucci R, Gori AM, Paniccia R, Giusti B, Valente S, Giglioli C, Buonamici P, Antoniucci D, Abbate R, Gensini GF. Cardiovascular death and nonfatal myocardial infarction in acute coronary syndrome patients receiving coronary stenting are predicted by residual platelet reactivity to ADP detected by a point-of-care assay: a 12-month follow-up. Circulation. January 20, 2009;119:237-242.Marcucci R, Gori AM, Paniccia R, Giusti B, Valente S, Giglioli C, Buonamici P, Antoniucci D, Abbate R, Gensini GF. Cardiovascular death and nonfatal myocardial infarction in acute coronary syndrome patients receiving coronary stenting are predicted by residual platelet reactivity to ADP detected by a point-of-care assay: a 12-month follow-up. Circulation. January 20, 2009;119:237-242.Gori AM, Marcucci R, Migliorini A. Incidence and Clinical Impact of Dual Nonresponsiveness to Aspirin and Clopidogrel in Patients With Drug-Eluting Stents. J Am Coll Cardiol 2008, August 26; 52:734–9.Gori AM, Marcucci R, Migliorini A. Incidence and Clinical Impact of Dual Nonresponsiveness to Aspirin and Clopidogrel in Patients With Drug-Eluting Stents. J Am Coll Cardiol 2008, August 26; 52:734–9.Angiolillo DJ, Shoemaker SB, Desai B, Yuan H, Charlton RK, Bernardo E, Zenni MM, Guzman LA, Bass TA, Costa MA. Randomised comparison of a high clopidogrel maintenance dose in patients with diabetes mellitus and coronary artery disease: results of the Optimizing Antiplatelet Therapy in Diabetes Mellitus (OPTIMUS) study: Circulation. 2007;115:708-716Angiolillo DJ, Shoemaker SB, Desai B, Yuan H, Charlton RK, Bernardo E, Zenni MM, Guzman LA, Bass TA, Costa MA. Randomised comparison of a high clopidogrel maintenance dose in patients with diabetes mellitus and coronary artery disease: results of the Optimizing Antiplatelet Therapy in Diabetes Mellitus (OPTIMUS) study: Circulation. 2007;115:708-716Price MJ, Berger PB, Teirstein PS, Tanguay JF, Angiolillo DJ, Spriggs D, Puri S, Robbins M, Garratt KN, Bertrand OF, Stillabower ME, Aragon JR, Kandzari DE, Stinis CT, Lee MS, Manoukian SV, Cannon CP, Schork NJ, Topol EJ. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA March 16 2011;305(11):1097-105Price MJ, Berger PB, Teirstein PS, Tanguay JF, Angiolillo DJ, Spriggs D, Puri S, Robbins M, Garratt KN, Bertrand OF, Stillabower ME, Aragon JR, Kandzari DE, Stinis CT, Lee MS, Manoukian SV, Cannon CP, Schork NJ, Topol EJ. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA March 16 2011;305(11):1097-10516. Boyden TF, Nallamothu BK, Moscucci M, Chan PS, Grossman PM, Tsai TT, Chetcuti SJ, Bates ER, Gurm HS. Meta-analysis of randomized trials of drug-eluting stents versus bare metal stents in patients with diabetes mellitus. Am J Cardiol. 2007 May 15;99(10):1399-40216. Boyden TF, Nallamothu BK, Moscucci M, Chan PS, Grossman PM, Tsai TT, Chetcuti SJ, Bates ER, Gurm HS. Meta-analysis of randomized trials of drug-eluting stents versus bare metal stents in patients with diabetes mellitus. Am J Cardiol. 2007 May 15;99(10):1399-402

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