Chapter 7 Coronary revascularization in the patient with diabetes
Stephen Wheatcroft
• Patients with diabetes represent a substantial proportion of patients undergoing coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI).
• The diffuse and rapidly progressive nature of coronary disease in individuals with diabetes poses significant challenges for revascularization.
• Despite recent technological advances in surgical and percutaneous techniques, clinical outcomes remain poorer for patients with diabetes compared to those without.
• Selection of revascularization strategy should be based on consideration of the severity and extent of coronary artery disease and the potential for complete revascularization.
• CABG is more effective than PCI in individuals with diabetes and multivessel disease, although the results of large ongoing randomized trials of drug-eluting stents in this setting are awaited.
Cardiovascular disease is a common cause of morbidity and mortality in people with diabetes, and it is an issue that is becoming increasingly important to cardiologists and specialists in diabetes. This second edition has been updated to include new trial data, new drugs and updates on treatment of diabetes in heart failure patients.
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
