Revascularization Strategies in Patients with Diabetes Mellitus and Acute Coronary Syndrome.
Patients with diabetes mellitus (DM) have more severe CAD and higher mortality in acute coronary syndrome (ACS) than patients without DM. The optimal mode of revascularization-coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)-remains controversial in this setting. For patients with DM and ST-segment elevation myocardial infarction, prompt revascularization of the culprit artery via PCI is generally preferable. In non-ST-elevation ACS, the decision on mode of revascularization is more challenging. Trials comparing CABG with percutaneous transluminal coronary angioplasty, bare metal stents, and first-generation drug-eluting stents in DM patients with multivessel have demonstrated decreased mortality in those receiving CABG. On the other hand, trials and retrospective analyses comparing CABG to PCI with second-generation drug-eluting stents have not shown a statistically significant mortality benefit favoring CABG. This potentially narrowed that gap between CABG and PCI requires further investigation.
['Buntaine|Adam J|AJ|', 'Shah|Binita|B|', 'Lorin|Jeffrey D|JD|', 'Sedlis|Steven P|SP|']
D054058:Acute Coronary Syndrome D015906:Angioplasty, Balloon, Coronary D001026:Coronary Artery Bypass D048909:Diabetes Complications D054855:Drug-Eluting Stents D006801:Humans D009203:Myocardial Infarction D009204:Myocardial Revascularization D016032:Randomized Controlled Trials as Topic D016896:Treatment Outcome
Diabetes mellitus Acute coronary syndrome Percutaneous coronary intervention Myocardial infarction Coronary artery bypass grafting