Clinical-functional characteristics of ischemic heart disease in connection with diabetes mellitus
The purpose of the study: optimization of coronary heart disease diagnostics in patients with diabetes mellitus (DM) by studying the clinical and functional characteristics of the coronary heart disease course in combination with DM type 2. 112 patients with coronary heart disease were examined, including 66 patients with a combination of coronary heart disease and diabetes and 46 patients with coronary heart disease without manifestations of diabetes. It was established that coronary artery disease at the diabetes mellitus develops at a younger age, is more pronounced and is characterized by a higher incidence and depth of ST segment segmentation, longer episodes of myocardial ischemia and their total daily duration, more frequent painless ischemia of the myocardium. In patients with diabetes mellitus coronary heart disease is often accompanied by a violation of the rhythm (ventricular and supraventricular extrasystoles, supraventricular tachycardia). The combination of diabetes and coronary heart disease increases the degree of pathological myocardial remodeling, mainly due to dilatation of the heart, contributes to the progression of systolic and diastolic dysfunction and increased arrhythmic activity. The absence of a typical clinical picture of coronary heart disease in patients with diabetes promotes later recognition, often at the stage of complications, which leads to the late appointment of adequate therapy.
2. 2. Dolzhenko, M. N., Perepelchenko, N. A., & Sokolova, L. K. (2008). Vliyanie saharnogo diabeta na razvitie ishemii miokarda u pacientov s ishemicheskoj boleznyu serdca po dannym holterovskogo monitorirovaniya EKG. Ukrainskyi kardiolohichnyi zhurnal, 3, 41–46. [in Russian]. [in Russian].
3. 2013 ESC guidelines on the management of stable coronary artery disease. (2013). European Heart Journal, 34(38), 2949–3003. doi:10.1093/eurheartj/eht296
4. D’Agostino, R. B., Hamman, R. F., Karter, A. J., Mykkanen, L., Wagenknecht, L. E., & Haffner, S. M. (2004). Cardiovascular Disease Risk Factors Predict the Development of Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study. Diabetes Care, 27(9), 2234–2240. doi:10.2337/diacare.27.9.2234
5. Diagnosis and Classification of Diabetes Mellitus. (2009). Diabetes Care, 33(Supplement_1). doi:10.2337/dc10-s062
6. Huxley, R., Barzi, F., & Woodward, M. (2006). Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ, 332(7533), 73–78. doi:10.1136/bmj.38678.389583.7c
7. Juutilainen, A., Lehto, S., Ronnemaa, T., Pyorala, K., & Laakso, M. (2005). Type 2 Diabetes as a “Coronary Heart Disease Equivalent”: An 18-year prospective population-based study in Finnish subjects. Diabetes Care, 28(12), 2901–2907. doi:10.2337/diacare.28.12.2901
8. Khaw, K., Wareham, N., Bingham, S., Luben, R., Welch, A., & Day, N. (2004). Association of hemoglobin A1c with cardiovascular disease and mortality in adults: The European prospective investigation into cancer in Norfolk. Annals of Internal Medicine Logo, 141(6), 413–420. doi:10.7326/0003-4819-141-6-200409210-00006
9. Lee, W. L., Cheung, A. M., Cape, D., & Zinman, B. (2000). Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies. Diabetes Care, 23(7), 962–968. doi:10.2337/diacare.23.7.962
10. Murcia, A. M., Hennekens, C. H., Lamas, G. A., Jiménez-Navarro, M., Rouleau, J. L., Flaker, G. C., ... Pfeffer, M. A. (2004). Impact of Diabetes on Mortality in Patients With Myocardial Infarction and Left Ventricular Dysfunction. Archives of Internal Medicine, 164(20), 2273–2279. doi:10.1001/archinte.164.20.2273.
11. Ryden, L., Standl, E., Bartnik, M., Berghe, G. V., Betteridge, J., Boer, M. D., ... Wood, D. (2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). European Heart Journal, 28(1), 88–136. doi:10.1093/eurheartj/ehl260
12. Vinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003). Diabetic Autonomic Neuropathy. Diabetes Care, 26(5), 1553–1579. doi:10.2337/diacare.26.5.1553