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Interventional Management of Diabetic Coronaropathy and Diffuse Coronary Artery Disease

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PanVascular Medicine

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Abstract

Diabetes mellitus is a systemic risk factor for atherosclerosis. The presence of diabetes confers a higher risk for future cardiovascular and cerebrovascular events. While cardiovascular mortality has considerably declined over the last decades, the same degree of benefit has not been observed among diabetic patients. Compared with nondiabetic patients, diabetic patients who undergo revascularization have more extensive and diffuse atherosclerotic disease. Following revascularization, diabetic patients have worse survival and increased cardiac events, in part due to progression of coronary disease as well as associated comorbidities. Diabetes is also associated with increased rates of specific procedural complications such as restenosis, repeat revascularization, and stent thrombosis following percutaneous coronary intervention (PCI) and wound infection, acute renal failure, and neurological events following coronary artery bypass surgery (CABG). Several randomized controlled trials have compared outcomes following PCI and CABG in eligible patients with diabetes and multivessel disease. Compared to PCI, CABG is associated with improved long-term survival, reduced myocardial infarction, and repeat revascularization.

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Abbreviations

Bioabsorbable stent:

Stent which progressively disintegrates following implantation, eventually leaving virtually no traces of stent material in the coronary artery wall.

BMS, bare metal stents:

A scaffold-like device deployed at a narrowing in the vessel to help keep it open.

DES, drug-eluting stents:

Stent which slowly releases a drug that impairs the proliferation of smooth muscle cells.

In-stent restenosis:

The recurrent narrowing of an artery after stent placement.

PCI, percutaneous coronary intervention:

A procedure performed during cardiac catheterization where a stent is deployed at the site of significant obstruction or narrowing in the coronary artery to improve blood supply to the heart muscle.

POBA, plain old balloon angioplasty:

A procedure performed during cardiac catheterization where a balloon is inflated at the site of significant obstruction or narrowing in the coronary artery to improve blood supply to the heart muscle.

Stent thrombosis:

Formation of a blood clot in the stented coronary artery.

TLR, target lesion revascularization:

A repeat procedure at a previously treated lesion to restore blood flow to the tissues.

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Authors and Affiliations

  1. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 1080, New York, NY, 10029, USA

    Jennifer Yu MBBS, Jose M. Castellano M.D., Ph.D., Roxana Mehran M.D. & Valentin Fuster M.D., Ph.D.

  2. Centro Nacional de Investigaciones Cardiovasculares CNIC, Madrid, Spain

    Valentin Fuster M.D., Ph.D.

  3. Prince of Wales Clinical School, University of New South Wales, NSW, Australia

    Jennifer Yu MBBS

Authors
  1. Jennifer Yu MBBS
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  2. Jose M. Castellano M.D., Ph.D.
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  3. Roxana Mehran M.D.
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  4. Valentin Fuster M.D., Ph.D.
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Corresponding author

Correspondence to Roxana Mehran M.D. .

Editor information

Editors and Affiliations

  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Yu, J., Castellano, J.M., Mehran, R., Fuster, V. (2014). Interventional Management of Diabetic Coronaropathy and Diffuse Coronary Artery Disease. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_77-1

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  • DOI: https://doi.org/10.1007/978-3-642-37393-0_77-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-37393-0

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