Coronary artery disease and diabetes mellitus

Cardiol Clin. 2014 Aug;32(3):439-55. doi: 10.1016/j.ccl.2014.04.001. Epub 2014 Jun 10.

Abstract

Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM.

Keywords: Blood glucose; Coronary disease; Diabetes mellitus; Hypoglycemic agents; Revascularization; Statins.

Publication types

  • Review

MeSH terms

  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / surgery
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / therapy
  • Global Health
  • Glycemic Index*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Incidence
  • Myocardial Revascularization*
  • Prevalence
  • Risk Factors

Substances

  • Hypoglycemic Agents