临床最新进展：糖尿病中的心血管疾病：2型糖尿病中的动脉粥样硬化性心血管疾病和心力衰竭——机制、管理及临床考量
Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations.
作者信息
Low Wang Cecilia C, Hess Connie N, Hiatt William R, Goldfine Allison B
机构信息
From Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado School of Medicine, Aurora (C.C.L.); CPC Clinical Research, Aurora, CO (C.C.L., C.N.H., W.R.H.); Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (C.N.H., W.R.H.); Joslin Diabetes Center, and Harvard Medical School, Boston, MA (A.B.G.).
出版信息
Circulation. 2016 Jun 14;133(24):2459-502. doi: 10.1161/CIRCULATIONAHA.116.022194.
Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting.
心血管疾病仍然是糖尿病患者死亡和残疾的主要原因。糖尿病会加剧动脉粥样硬化和心力衰竭的潜在机制。不幸的是，目前可用的药物或方法仅专注于最佳血糖控制的治疗策略并不能充分调节这些机制。在使用他汀类药物和其他降脂药物、抗高血压治疗以及抗高血糖治疗策略进行多因素风险降低的情况下，心血管并发症发生率正在下降，但糖尿病患者的发生率仍高于非糖尿病患者。本综述探讨了糖尿病患者心血管管理的机制、历史、争议、新药以及当前指南的最新证据，以支持在非急性护理环境下对糖尿病和心脏病患者进行循证护理。
Zotero 插件