Clinical studies on coronary revascularization in patients with type 2 diabetes.
With the increasing prevalence, diabetes is rapidly growing into a global public health problem. Cardiovascular disease is a major consequence of this chronic condition, and a critical issue facing physicians worldwide today is choice of coronary revascularization procedures in treating these patients. Since the Bypass Angioplasty Revascularization Investigation (BARI) alert in 1995, there have been several reports on subgroup analysis of clinical trials and registries concerning revascularization among patients with diabetes. Although randomized control studies comparing percutaneous and surgical revascularization procedures in this high-risk group of patients are lacking, this article provides the background for the excess risk and reviews the findings of these investigations. Current strategies to improve outcomes in patients with diabetes undergoing coronary revascularization procedures are discussed.
Mak
Koon-Hou
KH
Department of Cardiology, National Heart Centre, Singapore, Singapore. mak_koon_hou@nhc.com.sg
Faxon
David P
DP
D017225:Atherectomy, Coronary / Q000379:methods; D002404:Catheterization / Q000379:methods; D003324:Coronary Artery Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000628:therapy*; D004730:Endothelium, Vascular; D005544:Forecasting; D020141:Hemostatic Disorders / Q000209:etiology; D006801:Humans; D007333:Insulin Resistance; D009204:Myocardial Revascularization / Q000379:methods*; D016019:Survival Analysis