[Treatment of diabetic patients with ischaemic heart disease].
Patients with diabetes constitute a large group among patients with ischaemic heart disease, and their risk of repeated cardiovascular events is large. Due to this, there is increasing focus on intervention against the increased risk of cardiac morbidity and mortality in patients with diabetes. Subgroup analyses of patients with diabetes from studies on patients with ischaemic heart disease show that intervention with thrombolysis, aspirin, beta blockers, ACE inhibitors and statins have similar relative benefit among patients with diabetes, but because of the greater risk in these patients, the absolute benefit is increased. In spite of this, intervention is less common among patients with diabetes, a fact that should be corrected. Direct intervention targeted at the metabolic disorder in ischaemic heart disease has only been investigated in the DIGAMI study, where glucose/insulin treatment followed by long term treatment with insulin was compared to conventional treatment. The mortality was lower in the insulin treated group after one to four years of follow up, a promising result which is currently being investigated in the DIGAMI-2 study.
Hildebrandt
P R
PR
H:S Frederiksberg Hospital, kardiologisk-endokrinologisk klinik E.
Snorgaard
O
O
Melchior
T M
TM
Seibaek
M B
MB
Torp-Pedersen
C T
CT
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008659:Metabolic Diseases / Q000150:complications / Q000188:drug therapy; D017202:Myocardial Ischemia / Q000150:complications / Q000188:drug therapy*; D019821:Simvastatin / Q000627:therapeutic use; D015912:Thrombolytic Therapy
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000960:Hypolipidemic Agents; D019821:Simvastatin; D001241:Aspirin