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Chapter-081 Acute Coronary Syndrome in Cardiodiabetes: Is It Different?

BOOK TITLE: Cardiodiabetes Update: A Textbook of Cardiology

Author
1. Mohan Gaurav
2. Wander GS
3. Sharma Ravina
ISBN
9789352703043
DOI
10.5005/jp/books/14130_82
Edition
1/e
Publishing Year
2018
Pages
5
Author Affiliations
1. Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
2. API; Hero DMC Heart Institute, Unit of DMC and Hospital, Ludhiana, Punjab, India, Dayanand Medical College and Hospital, Punjab, India, API–2017; Hero DMC Heart Institute; Unit of DMC and Hospital; Ludhiana, Punjab, India, Hero DMC Heart Institute Dayanand Medical College and Hospital Ludhiana, Punjab, India, API, Hero DMC Heart Institute, Dayanand Medical College and Hospital Ludhiana, Punjab, India; API, Hero DMC Heart Institute, Dayanand Medical College and Hospital, Ludhiana, Punjab, India; API, Hero DMC Heart Institute, Dayanand Medical College and Hospital, Ludhiana, Punjab, India, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
3. Dayanand Medical College and Hospital, Ludhiana, Punjab, India
Chapter keywords
Diabetes mellitus, DM, coronary artery bypass graft surgery, CABG, multivessel coronary disease, percutaneous coronary intervention, PCI, acute coronary syndrome, ACS, cardiovascular disease, CVD

Abstract

Diabetes mellitus (DM) is a rapidly growing pandemic disease affecting more than 350 million patients all over the world. DM patients have more progressive, diffuse, and multivessel coronary disease compared to nondiabetic patients and have poorer outcomes after both PCI and coronary artery bypass graft surgery (CABG), compared to nondiabetic patients. This chapter covers the pathophysiology of atherosclerosis in patients with type 2 diabetes mellitus postacute coronary syndrome and management of acute coronary syndrome in diabetes. In diabetic patients, Prasugrel leads to better and ticagrelor leads to a comparable reduction in ischemic events. Trials of chronic stable angina favor CABG as a better revascularization strategy compared to PCI in these patients but, individualization based on comorbidities, extent of plaque burden and age should be taken into account particularly in ACS patients as none of the studies have specifically studied this subgroup.

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