[Percutaneous coronary intervention in patients with diabetes mellitus].
The incidence of restenosis after percutaneous coronary intervention (PCI) in patients with ischemic heart disease and diabetes is increased compared to non-diabetics. The use of stents has reduced the incidence of restenosis significantly but the effect is not convincing, as restenosis in diabetics predominantly consists of intimal hyperplasia. Even with the use of stents, diabetics have increased morbidity and mortality compared to non-diabetics. The precise mechanism is unknown but may include the metabolic abnormalities characteristic of diabetes. No randomised prospective studies in diabetics compare coronary artery by-pass grafting (CABG) with optimal angioplastic therapy. We await such studies to clarify the conditions for diabetics. Retrospective subgroup analyses indicate a more favourable outcome in diabetics revascularised by CABG. Thus CABG is presumably the optimal revascularisation treatment for diabetics with three-vessel disease.
Søndergaard
Hanne Maare
HM
Kardiologisk afdeling B, Skejby Sygehus, Arhus Universitetshospital, DK-8200 Arhus N. hanne.sondergaard@dadlnet.dk
Bøtker
Hans Erik
HE
Bøttcher
Morten
M
Nielsen
Torsten Toftegaard
TT
D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000209:etiology / Q000601:surgery; D003327:Coronary Disease / Q000209:etiology / Q000601:surgery; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology*; D048909:Diabetes Complications; D003920:Diabetes Mellitus; D003925:Diabetic Angiopathies / Q000209:etiology / Q000601:surgery*; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome