[Screening and management of coronary artery disease in diabetic patients].
Diabetes represents as independent risk factor for coronary artery disease (CAD) and the prognosis in term of survival rates is worse for diabetic patients who have CAD with report to those with CAD but no diabetes. The coronary artery disease in diabetes has specificities and, in particular, more extensive atherosclerosis. Diabetic patients are also more frequently asymptomatic. Due to the extreme complexity of ischemic vascular disease in patients with diabetes, an optimal therapeutic strategy is based on the correction of elevated blood glucose and lipid levels, of blood pressure, of platelet and coagulation abnormalities. Diabetic patients benefit from secondary prevention by drug therapy(aspirin, lipid lowering with statines, beta blocker and ACE inhibitors) to the same extent as, or more than, non-diabetic patients. Both percutaneous and surgical myocardial revascularization have been proved equally effective for CAD treatment in diabetes. A recent randomized trial has shown a significantly improved outcome after surgical revascularization. But, the effects of drug-eluting stents, which dramatically decrease the incidence of re-stenosis, seem promising.
Kraiem
Sondos
S
Service de cardiologie, Hopiral Habib Thamteut, Tunis.
Abassi
Chedly
C
Annabi
Nizar
N
Smaali
Ibtissem
I
Issaa
Inès
I
Wali
Mouin
M
Malou
Monia
M
Hannachi
Sofiane
S
Longo
Selma
S
Battikh
Kaies
K
Slimane
Mohamed Lotfi
ML
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery / Q000628:therapy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009204:Myocardial Revascularization; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin