Cardiovascular disease: much more aggressive in patients with type 2 diabetes.
It is estimated that 80% of individuals with type 2 diabetes die of coronary heart disease. Several factors have been found to contribute to the accelerated atherosclerosis present in diabetic patients. These include hyperglycemia-induced endothelial cell dysfunction, impaired fibrinolysis, increased platelet aggregation, and dysfunctional arterial remodeling. The evidence supports that a healthy lifestyle, statin drugs, angiotensin-converting enzyme inhibitors, and aspirin can modify these factors and slow the atherosclerosis process observed in type 2 diabetes. Because of the high prevalence of cardiovascular disease in people with type 2 diabetes, early cardiac testing is indicated. The optimal strategy for coronary revascularization in diabetic patients remains controversial and is discussed in detail in this review.
Chiquette
Elaine
E
University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7872, USA.
Chilton
Robert
R
D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D009204:Myocardial Revascularization; D015607:Stents
D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin