Diabetes Mellitus in Acute Coronary Syndrome

Autor: Panagiota K. Stampouloglou, Artemis Anastasiou, Evanthia Bletsa, Stavroula Lygkoni, Flora Chouzouri, Maria Xenou, Ourania Katsarou, Panagiotis Theofilis, Konstantinos Zisimos, Dimitris Tousoulis, Manolis Vavuranakis, Gerasimos Siasos, Evangelos Oikonomou
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Life, Vol 13, Iss 11, p 2226 (2023)
Druh dokumentu: article
ISSN: 2075-1729
DOI: 10.3390/life13112226
Popis: The global prevalence of diabetes mellitus (DM) has led to a pandemic, with significant microvascular and macrovascular complications including coronary artery disease (CAD), which worsen clinical outcomes and cardiovascular prognosis. Patients with both acute coronary syndrome (ACS) and DM have worse prognosis and several pathophysiologic mechanisms have been implicated including, insulin resistance, hyperglycemia, endothelial dysfunction, platelet activation and aggregations as well as plaque characteristics and extent of coronary lesions. Therefore, regarding reperfusion strategies in the more complex anatomies coronary artery bypass surgery may be the preferred therapeutic strategy over percutaneous coronary intervention while both hyperglycemia and hypoglycemia should be avoided with closed monitoring of glycemic status during the acute phase of myocardial infraction. However, the best treatment strategy remains undefined. Non-insulin therapies, due to the low risk of hypoglycemia concurrently with the multifactorial CV protective effects, may be proved to be the best treatment option in the future. Nevertheless, evidence for the beneficial effects of glucagon like peptide-1 receptor agonists, dipeptidyl-peptidase 4 inhibitors and sodium glycose cotransporter 2 inhibitors, despite accumulating, is not robust and future randomized control trials may provide more definitive data.
Databáze: Directory of Open Access Journals
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