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Titolo:
Management of coronary artery disease: Therapeutic options in patients with diabetes
Autore:
Hammoud, T; Tanguay, JF; Bourassa, MG;
Indirizzi:
Montreal Heart Inst, Dept Med, Montreal, PQ H1T 1C8, Canada Montreal HeartInst Montreal PQ Canada H1T 1C8 ntreal, PQ H1T 1C8, Canada
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 2, volume: 36, anno: 2000,
pagine: 355 - 365
SICI:
0735-1097(200008)36:2<355:MOCADT>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; ACTIVATOR INHIBITOR TYPE-1; MOLECULAR-WEIGHT HEPARIN; ANGIOGRAPHIC FOLLOW-UP; INSULIN-RESISTANCE; HEART-DISEASE; CARDIOVASCULAR MORTALITY; NONDIABETIC PATIENTS; BALLOON ANGIOPLASTY; RANDOMIZED TRIAL;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
144
Recensione:
Indirizzi per estratti:
Indirizzo: Bourassa, MG Montreal Heart Inst, Res Ctr, 5000 Belanger St E, Montreal, PQ H1T 1C8, Canada Montreal Heart Inst 5000 Belanger St E Montreal PQ CanadaH1T 1C8
Citazione:
T. Hammoud et al., "Management of coronary artery disease: Therapeutic options in patients with diabetes", J AM COL C, 36(2), 2000, pp. 355-365

Abstract

OBJECTIVES The aim of this review is to discuss the particularities of coronary artery disease (CAD), the effect of intensive medical management and the outcome of percutaneous and surgical revascularization in patients withdiabetes mellitus (DM). BACKGROUND CAD represents the leading cause of death in patients with DM. Numerous clinical, biological and angiographic risk factors have been shownto be associated with CAD in diabetic patients. METHODS Metabolic abnormalities in patients with DM including insulin resistance, hyperglycemia and dyslipidemia are briefly discussed. Then the potential roles of medical management and of percutaneous and surgical coronaryrevascularization are more extensively reviewed. RESULTS More vigorous control of hyperglycemia, hyperlipidemia, hypertension and other risk factors may be of crucial importance for risk reduction. Despite remarkable progress in recent years, the choice of a coronary revascularization strategy remains a challenge in these patients. Diabetic patients with CAD are predisposed to higher cardiovascular events after balloon angioplasty. Whether stenting and new antiplatelet drugs improve the results of percutaneous revascularization in this population needs further evaluation. The superiority of the surgical approach is also not definitely established. Therefore, many aspects of coronary revascularization are still unclear in these patients. CONCLUSIONS The results of ongoing randomized trials comparing multiple coronary stents to bypass surgery will likely provide some answers to our questions and additional randomized trials evaluating intensive diabetic control with or without coronary revascularization are needed to determine the best therapeutic approach in these patients. (C) 2000 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/02/20 alle ore 15:05:11