Type two diabetes mellitus and microvascular complications in patients with coronary artery disease: prevalence, prognosis and choice of antithrombotic therapy

Abstract

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.