Acute coronary syndromes in diabetic patients, outcome, revascularization, and antithrombotic therapy

Elena Emilia Babes ¹Cristiana Bustea Tapan Behl Mohamed M. Abdel-Daim Aurelia Cristina Nechifor Manuela Stoicescu Cristina Mihaela Brisc Madalina Moisi Daniela Gitea Diana Carina Iovanovici Alexa Florina Bungau Delia Mirela Tit Simona Gabriela Bungau

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作者信息

1. Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073
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Abstract

Diabetes exacerbates the progression of atherosclerosis and is associated with increased risk of developing acute coronary syndrome (ACS). Approximatively 25-30% of patients admitted for ACS have diabetes. ACS occurs earlier in diabetics and is associated with increased mortality and a higher risk of recurrent ischemic events. An increased proinflammatory and prothrombotic state is involved in the poorer outcomes of diabetic patients. In the past decade advancement in both percutaneous coronary intervention (PCI) and coronary artery by-pass graft (CABG) techniques and more potent antiplatelet drugs like prasugrel and ticagrelor improved outcomes of diabetic patients with ACS, but this population still experiences worse outcomes compared to non-diabetic patients. While in ST elevation myocardial infarction urgent PCI is the method of choice for revascularization, in patients with non-ST elevation ACS an early invasive approach is suggested by the guidelines, but in the setting of multivessel (MV) or complex coronary artery disease (CAD) the revascularization strategy is less clear. This review describes the accumulating evidence regarding factors involved in promoting increased incidence and poor prognosis of ACS in patients with diabetes, the evolution over time of prognosis and outcomes, revascularization strategies and antithrombotic therapy studied until now.

Key words

Diabetes/Atherosclerosis/Acute coronary syndromes/Myocardial infarction/Percutaneous coronary intervention/Coronary artery by-pass graft/Drug eluting stents

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出版年

2022

Biomedicine & pharmacotherapy

SCI

ISSN：0753-3322

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