Myocardial revascularization in diabetic patients

Patients with diabetes mellitus (DM) are predisposed to diffuse and rapidly progressing forms of atherosclerosis which significantly increasesthe probabilityof surgical revascularization of myocardium. However, unique pathophysiological features of atherosclerosis in DM patients are responsibleforth...

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Autores principales:	Ivan Ivanovich Dedov, Sergey Anatol'evich Terekhin
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2010
Materias:	diabetes mellitus myocardial revascularization restenosis Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/511eba5cd5fb4753a3877213c7ba93fe
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spelling	oai:doaj.org-article:511eba5cd5fb4753a3877213c7ba93fe2021-11-14T09:00:15ZMyocardial revascularization in diabetic patients2072-03512072-037810.14341/2072-0351-6052https://doaj.org/article/511eba5cd5fb4753a3877213c7ba93fe2010-12-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/6052https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Patients with diabetes mellitus (DM) are predisposed to diffuse and rapidly progressing forms of atherosclerosis which significantly increasesthe probabilityof surgical revascularization of myocardium. However, unique pathophysiological features of atherosclerosis in DM patients are responsiblefortheirunusual reaction to an arterial injury associated with percutaneous coronary intervention (PCI).Numerousstudies showed that DM is an independentrisk factor of restenosis following successful balloon angioplasty or stenting of coronary arteries and significantly increases the need forsecondary myocardial revascularization that compromises the outcome of the treatment.Preliminary data indicate that the use of drug-releasing stentsdecreases the need for repeat interventions in both diabetic and non-diabetic patients without negative effect on certain clinical end-points, such asmyocardial infarction and mortality. Any surgical intervention causes less pronouncedimprovement of the clinical picture or prognosis in patients withfunctional class I or II angina of effort compared with optimal medicamental therapy. Surgical revascularization, PCI and aortocoronary bypasssurgery (ACB) is indicated to patients that remain symptomatic despite adequate conservative therapy. The choice of an optimal revascularizationstrategy is of primary importance for DM patients with multiple lesions in the coronary system. Randomized studies comparing multivascularPCI withballoon angioplasty and holometallic stents demonstrated the advantage of ACB for DM patients who showed a higher survival rate, lower frequencyof infarctions and secondary revascularization. Certain authors demonstrated that ACB surpasses PCI even when drug-releasing stents are used.It may be hoped that the ongoing randomized studies comparing the two modalities will help to develop the optimal strategy for myocardial revascularizationindiabetic patients.Ivan Ivanovich DedovSergey Anatol'evich TerekhinEndocrinology Research Centrearticlediabetes mellitusmyocardial revascularizationrestenosisNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 13, Iss 4, Pp 18-23 (2010)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetes mellitus myocardial revascularization restenosis Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetes mellitus myocardial revascularization restenosis Nutritional diseases. Deficiency diseases RC620-627 Ivan Ivanovich Dedov Sergey Anatol'evich Terekhin Myocardial revascularization in diabetic patients
description	Patients with diabetes mellitus (DM) are predisposed to diffuse and rapidly progressing forms of atherosclerosis which significantly increasesthe probabilityof surgical revascularization of myocardium. However, unique pathophysiological features of atherosclerosis in DM patients are responsiblefortheirunusual reaction to an arterial injury associated with percutaneous coronary intervention (PCI).Numerousstudies showed that DM is an independentrisk factor of restenosis following successful balloon angioplasty or stenting of coronary arteries and significantly increases the need forsecondary myocardial revascularization that compromises the outcome of the treatment.Preliminary data indicate that the use of drug-releasing stentsdecreases the need for repeat interventions in both diabetic and non-diabetic patients without negative effect on certain clinical end-points, such asmyocardial infarction and mortality. Any surgical intervention causes less pronouncedimprovement of the clinical picture or prognosis in patients withfunctional class I or II angina of effort compared with optimal medicamental therapy. Surgical revascularization, PCI and aortocoronary bypasssurgery (ACB) is indicated to patients that remain symptomatic despite adequate conservative therapy. The choice of an optimal revascularizationstrategy is of primary importance for DM patients with multiple lesions in the coronary system. Randomized studies comparing multivascularPCI withballoon angioplasty and holometallic stents demonstrated the advantage of ACB for DM patients who showed a higher survival rate, lower frequencyof infarctions and secondary revascularization. Certain authors demonstrated that ACB surpasses PCI even when drug-releasing stents are used.It may be hoped that the ongoing randomized studies comparing the two modalities will help to develop the optimal strategy for myocardial revascularizationindiabetic patients.
format	article
author	Ivan Ivanovich Dedov Sergey Anatol'evich Terekhin
author_facet	Ivan Ivanovich Dedov Sergey Anatol'evich Terekhin
author_sort	Ivan Ivanovich Dedov
title	Myocardial revascularization in diabetic patients
title_short	Myocardial revascularization in diabetic patients
title_full	Myocardial revascularization in diabetic patients
title_fullStr	Myocardial revascularization in diabetic patients
title_full_unstemmed	Myocardial revascularization in diabetic patients
title_sort	myocardial revascularization in diabetic patients
publisher	Endocrinology Research Centre
publishDate	2010
url	https://doaj.org/article/511eba5cd5fb4753a3877213c7ba93fe
work_keys_str_mv	AT ivanivanovichdedov myocardialrevascularizationindiabeticpatients AT sergeyanatolevichterekhin myocardialrevascularizationindiabeticpatients
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Myocardial revascularization in diabetic patients

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