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Diabetes and Coronary Artery Disease

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Book cover Controversies in Cardiology

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Abstract

Diabetes is a major risk factor for developing aggressive coronary artery disease. Since lifestyle modification and glycemic control efforts have not proven to reduce long term mortality, management still hinges on medical therapy and invasive revascularization. Guideline recommended medical therapy targeting secondary prevention efforts is warranted in all patients with diabetes and coronary artery disease. Higher risk populations benefit from revascularization, with coronary artery bypass grafting providing durable reductions in myocardial infarction and mortality relative to contemporary percutaneous coronary revascularization. However, coronary artery bypass grafting is not the appropriate approach in all patients, given elevated risk of short term stroke and equivalent long term symptom relief. Thus, controversy exists as to the appropriate management strategy in different sub groups. We advocate for an interdisciplinary heart team approach to provide a balanced perspective on the various options and a thoughtful discussion of the risks and benefits for each patient.

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Author information

Authors and Affiliations

  1. Division of Cardiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA

    Sanjum S. Sethi MD, MPH

  2. Division of Cardiology, The Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre of Excellence, Toronto, ON, Canada

    Michael E. Farkouh MD, MSc

  3. Department of Medicine, University of Toronto, Toronto, ON, Canada

    Michael E. Farkouh MD, MSc

Authors
  1. Sanjum S. Sethi MD, MPH
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  2. Michael E. Farkouh MD, MSc
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Editor information

Editors and Affiliations

  1. UCSF Fresno, Fresno, California, USA

    John A. Ambrose

  2. Department of Interventional Cardiology, Otamendi Hospital, Buenos Aires, Argentina

    Alfredo E. Rodríguez

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© 2015 Springer International Publishing Switzerland

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Sethi, S.S., Farkouh, M.E. (2015). Diabetes and Coronary Artery Disease. In: Ambrose, J., Rodríguez, A. (eds) Controversies in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-20415-4_4

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  • DOI: https://doi.org/10.1007/978-3-319-20415-4_4

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20414-7

  • Online ISBN: 978-3-319-20415-4

  • eBook Packages: MedicineMedicine (R0)

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