Coronary artery disease in type 2 diabetes mellitus: Recent treatment strategies and future perspectives

World J Cardiol. 2015 Mar 26;7(3):119-24. doi: 10.4330/wjc.v7.i3.119.

Abstract

Patients with type 2 diabetes mellitus (T2DM) are at a higher risk of developing coronary artery disease (CAD) than are non-T2DM patients. Moreover, the clinical outcomes in CAD with T2DM are poor despite improvements in medications and other interventions. Coronary artery bypass grafting is superior to percutaneous coronary intervention in treating multivessel coronary artery disease in diabetic patients. However, selecting a revascularization strategy depends not only on the lesion complexity but also on the patient's medical history and comorbidities. Additionally, comprehensive risk management with medical and non-pharmacological therapies is important, as is confirmation regarding whether the risk-management strategies are being appropriately achieved. Furthermore, non-pharmacological interventions using exercise and diet during the earlier stages of glucose metabolism abnormalities, such as impaired glucose tolerance, might be beneficial in preventing the development or progression of T2DM and in reducing the occurrence of cardiovascular events.

Keywords: Comprehensive risk management; Diabetes; Drug-eluting stents; Multivessel disease; Percutaneous coronary intervention.