Document Detail


Diabetes mellitus in coronary artery surgery: therapeutic strategies in the light of recent studies.
MedLine Citation:
PMID:  15573276     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Advances in percutaneous coronary revascularization have meant that, increasingly, patients with multivessel diseases are initially treated with the methods of interventional cardiology. Ongoing studies involving new stent coatings and optimized anti-thrombotic therapies could help to lower future restenosis rates and improve the success rate of stenting. Thrombocyte glycoprotein IIb/IIIa receptor blockers have already been shown to reduce the rate of acute PTCA complications in high-risk patients and could have a sustained impact on the long-term prognoses for PTCA patients. However, for diabetic patients with coronary multivessel diseases, coronary artery bypass grafting using arterial grafts as the initial revascularization method must be given preference over other therapy methods. Consequently, this group of patients is bound to grow in importance in cardiac surgery. The advances made in percutaneous coronary revascularization and in coronary surgery call for further prospective, controlled, randomized clinical studies in order to establish the best possible treatment strategy for patients with diabetes. It should be noted, however, that the therapeutic effect of myocardial revascularization is generally limited to individual coronary-arterial segments, whereas the pathological process of atherosclerosis is rather diffuse. The surgical strategy should therefore be seen as part of an overall strategy which encompasses other forms of treatment (e.g. intensive efforts to improve control of blood glucose level, blood pressure, and cholesterol level) in order to arrest the general progression of the disease and to reduce the risk of myocardial infarction and death.
Authors:
A H Lauruschkat; J Ennker
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  52     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-01     Completed Date:  2006-07-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  349-55     Citation Subset:  IM    
Affiliation:
Department of Cardiac, Thoracic and Vascular Surgery, Heart Institute Lahr/Baden, Hohbergweg 2, 77933 Lahr, Germany. Lauruschkat@heart-lahr.com
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Blood Glucose / metabolism
Blood Pressure
Clinical Trials as Topic
Coronary Artery Bypass* / adverse effects
Coronary Disease / blood,  physiopathology,  surgery,  therapy*
Diabetes Mellitus / blood,  physiopathology,  therapy*
Diabetic Nephropathies / etiology
Diabetic Neuropathies / etiology
Fibrinolytic Agents / therapeutic use
Humans
Lipid Metabolism
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Fibrinolytic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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