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Updated: Apr 5, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Diabetes is not sufficient justification for IIb/IIIa use in percutaneous coronary intervention
1Heath South Cardiovascular Group, Alabaster, Alabama.
Insights
Diabetics undergoing percutaneous coronary intervention (PCI) face higher risks of ischemic and bleeding events. Bivalirudin with provisional glycoprotein IIb/IIIa therapy reduces bleeding and mortality in these patients compared to routine IIb/IIIa use.
Area of Science:
- Cardiology
- Endocrinology
- Vascular Medicine
Background:
- Diabetes mellitus increases risks for atherothrombotic and bleeding complications during percutaneous coronary intervention (PCI).
- Insulin-treated diabetic patients exhibit a heightened susceptibility to adverse events post-PCI.
- The risk-benefit ratio of antithrombotic strategies is altered in diabetic populations.
Abstract:
Diabetics, particularly insulin treated, have increased risk of ischemic events and bleeding with percutaneous coronary intervention (PCI). The relative risk of atherothrombotic versus bleeding events is higher in diabetics than non-diabetics. Bivalirudin with provisional IIb/IIIa therapy has less bleeding and lower one-year mortality than routine IIb/IIIa therapy in diabetics undergoing PCI. IIb/IIIa agents should be reserved for provisional and niche applications during PCI.
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