[Coronary angioplasty in diabetic patients].
Increased thrombogenicity, endothelial dysfunction, proliferation of both the cells and the matrix in the vessel walls, dislipidemia and insulin-resistance are the main metabolic alterations in the diabetic scenario, with possible implications in terms of vessel restenosis after coronary angioplasty. The outcome of balloon coronary angioplasty in diabetics is poor. This is due to both increased restenosis and a high incidence of medium/long-term cardiac events; the use of stents in these patients has substantially improved the results, but the recurrence rate has not been abated to the level observed in the general population. Abciximab may be a helpful adjunct to coronary angioplasty in these patients, while coronary artery bypass grafting may still be preferable--as at present--in case of multivessel coronary artery disease. This viewpoint is likely to be substantially modified in the near future, if the promise of "zero restenosis" devices is kept.
Steffenino
Giuseppe
G
Laboratorio di Emodinamica Divisione di Cardiologia Azienda Ospedaliera SS. Croce e Carle Via M. Coppino, 26 12100 Cuneo. steffenino.g@scroce.sanitacn.it
La Scala
Eugenio
E
Riva
Lucilla
L
Menardi
Endrj
E
D015906:Angioplasty, Balloon, Coronary; D001786:Blood Glucose / Q000032:analysis; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000628:therapy*; D023903:Coronary Restenosis / Q000150:complications / Q000628:therapy; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood; D006801:Humans; D012307:Risk Factors; D015607:Stents
D001786:Blood Glucose