Abstract:
Background: Diabetes mellitus (DM) is one of the most crucial risk factors for morbidity and mortality from coronary heart disease (CAD) in the
contemporary world. The prevalence and rapid progression of atherosclerotic lesions leading to worse survival is a defining feature of the course of CAD
in patients with DM. Clinical manifestations of CAD often call for revascularization in patients with DM. The contemporary data regarding efficacy of
the coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with CAD and concomitant DM are summarized
in the review.
Conclusions: Worse survival prognosis in case of CAD with concomitant DM is associated with systemic atherosclerosis, presence of a number of
concomitant risk factors, as well as masked clinical manifestations of ischemia and myocardial infarction common for the patients with DM. The combination
of CAD and DM once again proves the benefit of the long-term use of drugs for the secondary prevention of cardiovascular events. From the standpoint
of evidence-based medicine the optimal method of revascularization in CAD patients with multivessel coronary artery disease and concomitant DM is
CABG surgery. In FREEDOM study surgical myocardial revascularization reduced the number of endpoints compared to PCI. In the case of PCI it is
advisable that eluting stents reducing the likelihood of restenosis and the need for repeated revascularization be used.
Description:
Department of Physiology, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova, Department of Cardiology and Angiology, Charité University Clinic, Berlin, Germany
