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[Diabetes and ischemic cardiopathy].

F Piscione1, E Barbato, G Galasso

  • 1Cattedra di Cardiologia Università degli Studi Federico II Via S. Pansini, 5 80131 Napoli. piscione@unina.it

Italian Heart Journal. Supplement : Official Journal of the Italian Federation of Cardiology
|October 26, 2001
PubMed
Summary
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Spontaneous coronary artery dissection: do we need different tailored strategies?

International journal of cardiology·2023

Diabetes significantly worsens coronary artery disease (CAD) outcomes and increases heart attack risk. Optimal management involves controlling blood sugar, lipids, blood pressure, and coagulation factors.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Biology

Context:

  • Diabetes mellitus is a major independent risk factor for coronary artery disease (CAD).
  • Diabetic patients with CAD exhibit poorer survival rates and a higher incidence of acute coronary events.
  • Diabetics present with accelerated and more severe atherosclerotic vascular disease.

Purpose:

  • To review the complex interplay between diabetes and CAD.
  • To discuss the multifactorial nature of ischemic vascular disease in diabetes.
  • To highlight current and emerging therapeutic strategies for managing CAD in diabetic patients.

Summary:

  • Diabetes exacerbates atherosclerosis, leading to increased risk of plaque ulceration and thrombus formation.
  • Abnormalities in coronary vessel structure, flow, and coagulation contribute to severe vascular disease in diabetics.

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  • Effective treatment requires comprehensive management of hyperglycemia, dyslipidemia, hypertension, and hemostatic dysregulation.

    • Impact:

    • Optimal therapeutic strategies necessitate aggressive correction of all risk factors.
    • Both percutaneous coronary intervention and surgical revascularization are effective, with recent data favoring surgery.
    • Targeting advanced glycation end-products offers novel treatment avenues, underscoring the need for further clinical trials.