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Revascularization in Patients with Diabetes: PCI or CABG or None at All

  • Diabetes and Cardiovascular Disease (S Malik, Section Editor)
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Abstract

Patients with diabetes have a high incidence of coronary artery disease, with particularly high rates of acute coronary syndromes and mortality. Revascularization by coronary artery bypass grafting was found to be effective in reducing angina and mortality in patients with extensive coronary artery disease over 30 years ago. Percutaneous coronary intervention, particularly with drug-eluting stents, has more recently been demonstrated to reduce recurrent angina and improve quality of life in diabetic patients with less extensive coronary artery disease. Most recently, coronary artery bypass grafting has been shown to be superior to percutaneous coronary intervention in improving mortality in patients with diabetes and three-vessel coronary artery disease who are not at high surgical risk. The role of coronary artery bypass grafting vs. percutaneous coronary intervention in patients who have less extensive coronary artery disease and/or higher surgical risk has not been fully elucidated. Newer treatment strategies, such as percutaneous coronary intervention with second-generation drug-eluting stents, use of fractional flow reserve guidance, or hybrid revascularization combining minimally invasive coronary artery bypass grafting with percutaneous coronary intervention, may result in further improvements in outcomes in patients with diabetes and coronary artery disease.

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Kreton Mavromatis and Habib Samady declare that they have no conflict of interest.

Spencer B. King is on the Data Safety Monitoring Board for Harvard Clinical Research Institute, Duke University, Capricor, Inc., and Merck & Company and is on the Advisory Board for Celonova Biosciences.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Atlanta VA Medical Center, Decatur, GA, USA

    Kreton Mavromatis

  2. Emory University School of Medicine, 5665 Peachtree Dunwoody Road, NE, Atlanta, GA, 30342, USA

    Kreton Mavromatis, Habib Samady & Spencer B. King III

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  1. Kreton Mavromatis
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Correspondence to Spencer B. King III.

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This article is part of the Topical Collection on Diabetes and Cardiovascular Disease

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Mavromatis, K., Samady, H. & King, S.B. Revascularization in Patients with Diabetes: PCI or CABG or None at All. Curr Cardiol Rep 17, 12 (2015). https://doi.org/10.1007/s11886-015-0565-0

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