Key result
Microvascular disease in diabetic CHD patients is linked to higher cardiovascular risk requiring tailored antithrombotic therapy.
Why the study?
Does tailored antithrombotic therapy improve outcomes in patients with coronary artery disease and type 2 diabetes mellitus with microvascular complications?
Does tailored antithrombotic therapy improve outcomes in patients with coronary artery disease and type 2 diabetes mellitus with microvascular complications?
Highlights the high cardiovascular risk associated with microvascular complications in patients with CAD and T2DM and reviews antithrombotic options to balance ischemic and bleeding risks.
Answers are grounded in this paper and cite their sources.
May support intensified risk assessment in CAD with T2DM; leaves open whether tailored antithrombotic regimens improve outcomes.
The review presents the prevalence of both type 2 diabetes mellitus (type 2 DM) and its microvascular complications among patients with coronary heart disease (CHD), and CHD among patients with carbohydrate metabolism disorders. It is shown, that the prognosis of patients with CHD and type 2 DM, especially in the presence of microvascular complications, is extremely unfavorable, and is characterized by a significant increase in the risk of cardiovascular death, myocardial infarction, stroke, terminal stage of the chronic kidney disease and visual impairment. It was noted, that despite the successes achieved in the treatment of CHD, type 2 DM and its microvascular complications, there is a high risk of total, cardiovascular mortality and hospitalizations associated with cardiovascular diseases. In type 2 DM, especially in the presence of microvascular complications and comorbid pathology, special pathogenetic mechanisms of thrombotic risk and bleeding have been identified. Based on large randomized clinical trials, the review evaluated the efficacy and safety of various antithrombotic strategies in patients with stable СРВ, type 2 DM in the presence of microvascular complications and comorbid pathology.
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Козиолова et al. (2022) conducted a review in Coronary artery disease and type 2 diabetes mellitus with microvascular complications. Antithrombotic therapy was evaluated. In patients with coronary heart disease and type 2 diabetes, the presence of microvascular complications is associated with a significantly increased risk of cardiovascular events, necessitating tailored antithrombotic therapy.
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