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Percutaneous coronary intervention in diabetic patients with non-st-segment elevation acute coronary syndromes

Academic Article
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Overview

authors

  • Roffi, M.
  • Topol, Eric

publication date

  • 2004

journal

  • European Heart Journal  Journal

abstract

  • Key pathophysiologic mechanisms of diabetes-related coronary disease include inflammation and a prothrombotic state. In the setting of non-ST-segment elevation acute coronary syndromes diabetic patients are at high risk for subsequent cardiovascular events. At the same time, they derive greater benefit than non-diabetic counterparts from aggressive antithrombotic therapy, early coronary angiography, and stent-based percutaneous coronary intervention. The mainstays of antithrombotic therapy for diabetic patients undergoing percutaneous revascularization include aspirin, clopidogrel, platelet glycoprotein IIb/IIIa receptor antagonists, and heparin or low-molecular-weight heparin. Despite dramatic reduction in restenosis conferred by drug-eluting stents, diabetic patients remain at increased risk for repeat revascularization. More efforts are needed both in terms of local drug elution as well as systemic pharmacologic therapies to further contain the excessive neointimal proliferation that characterizes the diabetic response to vascular injury.

subject areas

  • Angioplasty, Balloon, Coronary
  • Coronary Artery Bypass
  • Coronary Artery Disease
  • Coronary Restenosis
  • Diabetic Angiopathies
  • Drug Implants
  • Drug Therapy, Combination
  • Humans
  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Stents
  • Syndrome
  • Thiazolidinediones
  • Ticlopidine
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Research

keywords

  • acute coronary syndromes
  • antiplatelet therepy
  • diabetes
  • glycoproteins
  • intervention
  • percutaneous coronary
  • stents
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Identity

International Standard Serial Number (ISSN)

  • 0195-668X

Digital Object Identifier (DOI)

  • 10.1016/j.ehj.2003.10.027

PubMed ID

  • 14972418
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Additional Document Info

start page

  • 190

end page

  • 198

volume

  • 25

issue

  • 3

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