Urgent revascularization strategies in patients with diabetes mellitus and acute coronary syndromes

Publication date: Available online 20 March 2019Source: Canadian Journal of CardiologyAuthor(s): Lucas C. Godoy, Patrick R. Lawler, Michael E. Farkouh, Bronwyn Hersen, José C. Nicolau, Vivek RaoAbstractThe prevalence of diabetes mellitus (DM) is rising globally and in Canada. Besides being a risk factor for the development of coronary artery disease, DM is also a marker of poor prognosis in patients with acute coronary syndrome (ACS), increasing the risks for both ischemic and bleeding complications. Patients with DM have a high prevalence of multivessel coronary artery disease (MVD) and robust evidence has supported coronary artery bypass surgery (CABG) as the optimal revascularization strategy in the setting of stable ischemic heart disease (SIHD). In the acute scenario, particularly in patients with non-ST segment elevation ACS (NSTE-ACS), there are many uncertainties regarding the best revascularization strategy. Most guidelines suggest an invasive and timely approach (that is, performing coronary catheterization within 72h after the onset of the NSTE-ACS) and make recommendations about choosing between PCI or CABG based on data for patients with SIHD. Recent observational and subgroup analyses suggest that CABG may be the preferential method of revascularization for patients with DM and MVD also in the NSTE-ACS setting; however, dedicated randomized clinical trials are lacking. Finally, in patients presenting with a ST-segment elevation myocardial infarction (STEM...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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Publication date: August 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 8Author(s): Lucas C. Godoy, Patrick R. Lawler, Michael E. Farkouh, Bronwyn Hersen, José C. Nicolau, Vivek RaoAbstractThe prevalence of diabetes mellitus (DM) is rising globally and in Canada. Besides being a risk factor for the development of coronary artery disease, DM is also a marker of poor prognosis in patients with acute coronary syndrome (ACS), increasing the risks for ischemic and bleeding complications. Patients with DM have a high prevalence of multivessel coronary artery disease (MVD) and robust evidence has supported co...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
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