Issues and challenges with antithrombotic therapy in diabetic patients with acute coronary syndromes.
Diabetes mellitus is associated with significant morbidity and mortality in the setting of acute coronary syndromes. This increased risk is attributable, in large part, to the derangements in coagulation that can accompany the diabetic disease state. Patients with diabetes mellitus have disturbances in endothelial function, platelet function, and coagulation factors. Until recently, there has been little direct exploration of therapeutic measures to improve outcome specifically among diabetic patients with acute coronary syndromes. Fortunately, antithrombotic therapies that have proven benefit in the general population also seem to be beneficial among patients with diabetes, although optimal dosing for improved safety and efficacy in this population has yet to be established for many of these agents. Primary prevention strategies and strict attention to risk factor modification hold the greatest promise for improving long-term outcome.
Barsness
G W
GW
Mayo Clinic and Foundation, 200 1st Street SW, Rochester, MN 55905, USA. barsness.gregory@mayo.edu
D000789:Angina, Unstable / Q000188:drug therapy* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000503:physiopathology; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013577:Syndrome
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors