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Review

Controversies surrounding percutaneous coronary intervention in the diabetic patient

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Pages 633-648 | Received 17 Dec 2015, Accepted 27 Jan 2016, Published online: 24 Feb 2016
 

ABSTRACT

Diabetic patients with coronary artery disease are common and complex, with an aggressive progression of atherosclerosis, increased rate of stent complications, and increased rates of incomplete revascularization in multivessel disease compared to non-diabetic patients. In this review, we first discuss the pathophysiologic elements of insulin resistance and presentations of coronary artery disease in diabetic patients. Next, we outline the evolution and present the data on revascularization strategies on diabetic patient outcomes. The overall conclusion of our review is that a strategy of complete and durable revascularization and guideline-directed medical therapy currently provides the best possible chance at closing the gap between outcomes in patients with and without diabetes.

Financial and competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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