Potential mechanisms promoting restenosis in diabetic patients.
Diabetes is associated with greater restenosis rates after successful balloon angioplasty. The metabolic alterations that occur as a result of hyperglycemia or hyperinsulinemia can accelerate many of the pathophysiologic processes that lead to restenosis. Diabetes results in endothelial dysfunction and accelerated platelet deposition, which increase the propensity to thrombosis. Several growth factors known to promote the restenosis process are overexpressed in the presence of hyperglycemia. Advanced glycosylation promotes inflammatory cell recruitment and smooth muscle cell proliferation. Many of the potential mechanisms promoting restenosis in diabetic patients can be ameliorated by improved metabolic control.
Aronson
D
D
Department of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
Bloomgarden
Z
Z
Rayfield
E J
EJ
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D003327:Coronary Disease / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000293:injuries / Q000503:physiopathology; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D010974:Platelet Aggregation; D012008:Recurrence; D012307:Risk Factors
D006133:Growth Substances