Key result
Diabetes mellitus is a major risk factor in patients with acute coronary syndromes, associated with more complex coronary artery disease and poorer clinical outcomes despite therapeutic advances.
This review highlights the pathophysiological mechanisms and clinical evidence demonstrating that diabetes worsens outcomes in acute coronary syndromes and supports CABG over PCI for multivascular disease in these patients.
Diabetes identifies higher-risk ACS patients for intensified monitoring; confirms prior associations while leaving optimal strategies open to trials.
Cardiovascular disease is the leading cause of death in the world, causing over 17 million deaths annually, of which 7.2 million by coronary heart disease. They are a major public health problem worldwide, of which acute coronary syndromes show special attention due to increased prevalence and incidence and poor prognosis. Although advanced therapies can improve the morbidity and mortality associated with acute coronary syndromes in well-developed countries, developing countries remain exposed to the ravages of these diseases. Of the patients admitted for acute coronary syndrome, about 30% suffer from diabetes mellitus, considered a major risk factor and a predictor for unfavorable evolution regardless of the type of acute coronary syndrome.
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Pașc et al. (2018) conducted a review in Acute coronary syndromes and diabetes mellitus. Diabetes mellitus vs. Non-diabetic patients was evaluated. Diabetes mellitus is a major risk factor in patients with acute coronary syndromes, associated with more complex coronary artery disease and poorer clinical outcomes despite therapeutic advances.
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