2017

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2017/№4

Diagnosis and correction of carbohydrate metabolism disorders before elective transcutaneous coronary intervention in conditions of real-life clinical practice

Ignatova Y. S.1, Karetnikova V. N.1, Kochergina A. M.2, Gruzdeva O. V.2, Khorlampenko A. A.2, Barbarash O. L.2
1 – Kemerovo State Medical University, Voroshilova 22a, Kemerovo 650029
2 – Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovy Bulvar 6, Kemerovo 650002

Keywords: coronary heart disease, disorders of carbohydrate metabolism, diagnostic approach, therapeutic tactics

DOI: 10.18087/rhj.2017.4.2365

Background. Patients with IHD before elective transcutaneous coronary intervention (TCI) constitute a special category of patients. In this patient group, hyperglycemia is a predictor for unfavorable outcome of endovascular revascularization. Aim. To evaluate a diagnostic approach to and incidence of carbohydrate metabolism disorders (CMD) in patients with IHD who have indications for elective TCI in real-life clinical practice. Materials and methods. 200 medical records of patients with IHD admitted for elective myocardial revascularization to the Research Institute for Complex Issues of Cardiovascular Diseases. Patients with IHD who had previously undergone TCI, patients with a history of heart valve replacement, acute coronary syndrome, or exacerbation of a somatic disease were excluded from the study sample. Results. CMD were detected in 23.5% of patients with IHD and indications for elective TCI; 37 (18.5%) patients were diagnosed with DM, 10 (5%) patients – with impaired glucose tolerance (IGT); abnormal fasting glycaemia was not detected. Glycemic status of IHD patients was evaluated by fasting glycaemia at admission. Active diagnostic search for CMD (measurement of glycated hemoglobin, oral test for glucose tolerance) was not performed for IHD patients. DM was detected in two (1%) cases; cases of IGT were not verified. Most patients with DM (91.8%) received antihyperglycemic therapy while 100% of patients with IGT did not receive any non-drug or drug therapy. Conclusion. According to medical records, 23.5% of patients with IHD had CMD; new cases were detected only by data of glycemic profile (including fasting glycaemia at admission), which allowed to detect DM only in two (1 %) patients. Active diagnostic search for CMD was not performed. Managing patients with DM included dietary recommendations and hypoglycemic therapy; in CMD, correction of metabolic disorders was not performed.
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Ignatova Y. S., Karetnikova V. N., Kochergina A. M., Gruzdeva O. V., Khorlampenko A. A., Barbarash O. L. Diagnosis and correction of carbohydrate metabolism disorders before elective transcutaneous coronary intervention in conditions of real-life clinical practice. Russian Heart Journal. 2017;16 (4):253–259

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