Das Herz beim metabolischen Syndrom

The definition of metabolic syndrome includes the presence of at least three of the following criteria: dyslipidaemia, hyperglycaemia, hypertension, and obesitas. The risk for cardiovascular events is strongly elevated in patients with metabolic syndrome. Also in acute myocardial infarction, hyperglycaemia worsens the outcome to a comparable degree as in patients with established diabetes. Infusion of insulin, glucose, and potassium reduces the risk for cardiac events. Glycoprotein IIb/IIIa antagonists lower the mortality in diabetic patients after percutaneous coronary intervention for acute coronary syndrome to the level of nondiabetics. In stable coronary artery disease, the mode of coronary revascularisation has been the subject of controversies. Recent clinical trials demonstrate equal mortality outcomes after percutanous and surgical revascularisation. Drug-eluting stents reduce the restenosis rate even in small vessels and long lesions as often present in diabetic patients. Drug therapy in patients with diabetes includes aspirin, statins, and inhibitors of the renin-angiotensin system – even for primary prevention of cardiovascular disease.