Percutaneous coronary revascularisation in diabetics

Abstract

Percutaneous coronary interventions (PCI) in diabetic patients represent the paradigm of a high-risk population with complex lesions. Due to the reduced number of randomised clinical trials (RCT) exclusively with diabetics, data presented in this review are mainly derived from subgroup, post-hoc analysis of diabetic patients included in RCTs and from meta-analysis. This might not represent the complex diabetic population seen in daily practice, and therefore selected data from single and multicentre registries are also discussed. Particular attention was paid to data relating to the recently introduced drug-eluting stents, their potential differences in relation to diabetes and the possible increase of late stent thrombosis, particularly in insulin-treated diabetics. It is emphasised that diabetes requires a multidisciplinary approach to control adequately both hyperglycaemia and other risk factors so that the benefits of the actual percutaneous revascularisation techniques could be fully explored.