Zusammenfassung
Diabetiker müssen mit den gleichen Präventionsmaßnahmen für Herz und Kreislauf behandelt
werden wie Nichtdiabetiker, die bereits einen Herzinfarkt erlebt und überlebt haben
- dies machen aktuelle Studiendaten deutlich. Bei einer Koronarintervention sollten
alle Diabetiker einen Drug-eluting-Stent erhalten und im Rahmen der Intervention mit
einem Glykoprotein-IIb/IIIa-Rezeptorenblocker behandelt werden. Doch nicht nur bei
der interventionellen koronaren Therapie muss man sich auf die besondere Stoffwechselsituation
beim Diabetiker einstellen. So müssen beim Diabetiker bereits leicht erhöhte Blutdruckwerte
konsequent behandelt werden. Essenziell ist dabei vor allem die AT1-Rezeptorblockade, weil diese die diabetische Stoffwechselsituation besonders günstig
beeinflussen kann. Aber auch die Therapie mit einem CSE-Hemmer ist bei Diabetikern
indiziert - sowohl in der Primär- als auch in der Sekundärtherapie und insbesondere
nach einer Koronarintervention.
Data from recent studies show that in diabetics the same measures for the prevention
of cardiovascular disease apply as in non-diabetics who have already suffered and
survived a myocardial infarction. All diabetics needing a coronary intervention should
receive a drug-eluting stent, as well as medication with a glycoprotein IIb/IIIa receptor
blocker. However, the need to take account of the particular metabolic situation presenting
in diabetics is not confined to treatment with a coronary intervention. For example,
diabetics with even mildly elevated blood pressure values need meticulous management.
An essential aspect of such therapy is AT1 receptor blockade, since this can have a particularly favourable impact on the metabolic
state in diabetics. But treatment with a CSE inhibitor is also indicated, both in
the primary and secondary treatment of diabetics, and in particular following a coronary
intervention.
Key Words
coronary intervention - PTCA - bypass - stents - platelet inhibitor - statins - AT1 receptor blockade
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Anschrift des Verfassers
Prof. Dr. W. Motz
Herz- und Diabeteszentrum
Klinikum Karlsburg
Greifswalder Str. 11, 17495 Karlsburg