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DOI: 10.1055/s-0031-1271434
© Georg Thieme Verlag KG Stuttgart ˙ New York
Hämostaseologische Aspekte der Atherothrombose bei Diabetes
Publication History
Publication Date:
07 April 2011 (online)
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Einleitung
Menschen mit Diabetes mellitus leiden und sterben nach wie vor besonders häufig an den mikro- und makrovaskulären Komplikationen ihrer Erkrankung. Besonders hoch ist dabei die Mortalität des akuten Koronarsyndroms und des zerebrovaskulären Insults [1] [2] . Über 60 % der Todesfälle unter männlichen insulintherapierten Typ-2-Diabetikern und über 50 % bei Diabetikerinnen im Alter zwischen 40 und 59 Jahren sind Folge ischämischer Schlaganfälle [3]. In der UKPDS-Studie wiesen bei Rekrutierungsstart bereits fast 50 % der Patienten mit Diabetes mellitus mikro- oder makrovaskuläre Komplikationen auf [4]. Dabei liegt dem typischen makrovaskulären Ereignis die Ruptur atherosklerotischer arterieller Plaques zugrunde, welche die Adhäsion und Aggregation von Thrombozyten auslöst, die schließlich einen arteriellen Gefäßverschluss mit konsekutiver Ischämie der Gefäßstrombahn bewirken [5]. Auch venöse Thromboembolien sind bei Diabetikern häufiger als bei Stoffwechselgesunden [6].
Die gesicherte Stellung des Diabetes mellitus als unabhängiger Risikofaktor thromboembolischer Ereignisse
Diabetes mellitus ist ein gesicherter unabhängiger Risikofaktor für thromboembolische Ereignisse. |
Die Wahl geeigneter präventiver und therapeutischer Maßnahmen sollte auf der Kenntnis der typischen Veränderungen basieren. Der vorliegende CME-Artikel soll deshalb dazu dienen, die wesentlichen diabetesassoziierten Störungen der Hämostase kurz zu rekapitulieren. Einige Therapiebesonderheiten sind für Diabetiker mit makrovaskulären Komplikationen in der Praxis zu beachten und haben teilweise Eingang in entsprechende Leitlinien gefunden.
- Literatur online
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Dr. med. H.-G. Kopp
Abteilung für Onkologie, Hämatologie, klinische Immunologie, Rheumatologie und Pulmologie · Medizinische Universitätsklinik Tübingen
Otfried Müller Straße 10
72076 Tübingen
Email: hans-georg.kopp@med.uni-tuebingen.de
- Literatur online
Das vollständige Literaturverzeichnis zu diesem Beitrag finden Sie im Internet:
Abonnenten und Nichtabonnenten können unter http://dx.doi.org/10.1055/s-0031-1271434 die Seite Diabetologie und Stoffwechsel (CME) aufrufen und beim jeweiligen Artikel auf „Literaturverzeichnis“ klicken – hier ist die Literatur für alle frei zugänglich.
Abonnenten können alternativ über ihren persönlichen Zugang an das Literaturverzeichnis gelangen. Wie das funktioniert, lesen Sie unter: https://www.thieme-connect.de/ejournals/help#video (Videoanleitung) oder https://www.thieme-connect.de/ejournals/help#SoRegistrieren (Schritt für Schritt)