La diabetes mellitus está presente en casi un tercio de los pacientes que presentan un síndrome coronario agudo y es considerada como un factor de riesgo cardiovascular independiente, que suele asociarse con hipertensión, obesidad y dislipemia. Las alteraciones metabólicas y hematológicas características de los diabéticos favorecen la progresión precoz, severa y rápida de la enfermedad coronaria. La prevención y el tratamiento óptimo del síndrome coronario agudo del diabético sigue siendo un desafío para la cardiología actual. El tratamiento multifactorial agresivo reduce la morbimortalidad de estos pacientes. Los bloqueadores beta y los trombolíticos proporcionan beneficio similar al de los no diabéticos, pero son infrautilizados. La mejor opción de tratamiento revascularizador, sobre todo en la enfermedad multivaso, continúa siendo controvertido. La liberación de stents y el uso de abciximab redujo de forma significativa las complicaciones de la angioplastia. Los injertos arteriales de mamaria mejoran el pronóstico a largo plazo y puede ser la mejor alternativa en la enfermedad multivaso.
Palabras clave
Hiperglucemia
Diabetes mellitus
Cardiopatía isquémica
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