Zusammenfassung
Die Mehrzahl der Patienten mit Diabetes mellitus verstirbt an akuten thrombotischen Komplikationen bereits lädierter Koronararterien. Die Grundlage dieser akuten ischämischen Ereignisse bildet bei Diabetes mellitus neben der sich beschleunigt entwickelnden Atherosklerose eine sekundäre funktionelle Hyperkoagulabilität (Gries et al. 1993; Yamada et al. 2000). Störungen der Blutgerinnung betreffen in zunehmendem Maß Diabetikerinnen und haben überragende Bedeutung für die klinische Prognose, da bei Diabetikern der Myokardinfarkt mit einer höheren Letalität verbunden ist als bei Nichtdiabetikern (Diabetes Epidemiology Research International Mortality Study Group 1991). Sie resultiert aus der Kombination von fortgeschrittenen, durch Mikroangiopathie bedingten Einschränkungen der Koronarreserve mit überschießenden hämostaseologischen Ischämiemechanismen (Jacoby u. Nesto 1992). Dies führt zu einer höheren Komplikationsrate nach angiologisch-kardiologischen Interventionen wie Thrombolyse, Bypassanlage und koronarer Angioplastie (Kip et al. 1996).
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Tschöpe, D. (2004). Gerinnungsstörungen. In: Waldhäusl, W.K., Gries, F.A., Scherbaum, W.A. (eds) Diabetes in der Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18571-7_31
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