title: Controversies surrounding percutaneous coronary intervention in the diabetic patient.
abstract: Diabetic patients with coronary artery disease are common and complex, with an aggressive progression of atherosclerosis, increased rate of stent complications, and increased rates of incomplete revascularization in multivessel disease compared to non-diabetic patients. In this review, we first discuss the pathophysiologic elements of insulin resistance and presentations of coronary artery disease in diabetic patients. Next, we outline the evolution and present the data on revascularization strategies on diabetic patient outcomes. The overall conclusion of our review is that a strategy of complete and durable revascularization and guideline-directed medical therapy currently provides the best possible chance at closing the gap between outcomes in patients with and without diabetes.
authors.affiliation: a Division of Cardiovascular Disease , Mayo Clinic , Rochester , MN , USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Martinez
authors.affiliation: a Division of Cardiovascular Disease , Mayo Clinic , Rochester , MN , USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
mesh_terms: D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000628:therapy*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome
keywords: BARI2D; Cabg; DES; PCI; bare metal stent; complete revascularization; diabetes; drug-eluting stent; hybrid revascularization; syntax