Acute coronary syndrome in the patient with diabetes: Is the management different?

被引：11

作者：

Amin A.P. ^{[1
]}

Marso S.P. ^{[1
]}

机构：

[1] Saint Luke's Mid America Heart Institute, Kansas City, MO 64111

来源：

Current Cardiology Reports | 2010年 / 12卷 / 4期

关键词：

Acute coronary syndrome; Antiplatelet agents; Clopidogrel; Diabetes mellitus; Drug-eluting stents; Percutaneous coronary intervention; Prasugrel; Revascularization;

D O I：

10.1007/s11886-010-0118-5

中图分类号：

学科分类号：

摘要：

Diabetic patients who present with an acute coronary syndrome (ACS) have a particularly adverse prognosis, largely contributed by increased platelet reactivity and higher burden of disease severity. Diabetic patients with ACS derive a greater benefit from established therapies, particularly platelet-inhibiting therapies, including clopidogrel pretreatment, and glycoprotein IIb/IIIa inhibitor use. Recent data show intense ADP-P2Y12 platelet receptor inhibition with prasugrel is of particular clinical value in the diabetic patient with ACS, without excessive bleeding. Diabetic patients with ACS also benefit more from aggressive revascularization strategies. Recent data show the benefit of drug-eluting stents in the setting of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction in decreasing target vessel revascularization up to 2 years, particularly in patients at highest risk for restenosis with bare metal stents (likely diabetic patients). This review summarizes the data supporting the key pharmacologic and revascularization management strategies to guide the clinician in taking care of diabetic patients who present with an ACS event. © Springer Science+Business Media, LLC 2010.

引用

页码：321 / 329

页数：8

共 48 条

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