title: Optimal approaches to diabetic patients with multivessel disease.
abstract: The pathophysiology of diabetes and systemic insulin resistance contributes to the nature of diffuse atherosclerosis and a high prevalence of multivessel coronary artery disease (CAD) in diabetic patients. The optimal approach to this patient population remains a subject of an ongoing discussion. In this review, we give an overview of the unique pathophysiology of CAD in patients with diabetes, summarize the current state of therapies available, and compare modalities of revascularization that have been investigated in recent clinical trials. We conclude by highlighting the importance of a comprehensive heart team approach to every patient while accommodating both patient preference and quality-of-life decisions.
authors.affiliation: Department of Medicine, New York University Langone Medical Center, New York, NY.
authors.forename: Louai
authors.initials: L
authors.lastname: Razzouk
authors.affiliation: Peter Munk Cardiac Centre, University of Toronto, Toronto, Ontario, Canada; Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, Ontario, Canada. Electronic address: michael.farkouh@mssm.edu.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002317:Cardiovascular Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy*; D003362:Cost-Benefit Analysis; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D007333:Insulin Resistance; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000401:mortality; D011788:Quality of Life; D012307:Risk Factors; D040242:Risk Reduction Behavior; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002317:Cardiovascular Agents