Roffi, Marco; Eberli, Franz R (2009). Diabetes and acute coronary syndromes. Best practice & research - clinical endocrinology & metabolism, 23(3), pp. 305-16. London: Baillière Tindall 10.1016/j.beem.2009.01.003
Full text not available from this repository. (Request a copy)Diabetic patients with acute coronary syndromes (ACSs) are at a high risk for subsequent cardiovascular events but derive, at the same time, greater benefit from evidence-based therapy than non-diabetic individuals. State-of-the-art anti-thrombotic therapy includes a triple anti-platelet combination - aspirin, clopidogrel and glycoprotein (GP) IIb/IIIa receptor inhibitors - and unfractionated heparin or enoxaparin. For low- or medium-risk individuals, a treatment based on aspirin, clopidogrel and bivalirudin is a valuable alternative. Prasugrel, a new and more potent inhibitor of the platelet P2Y(12) receptor, has to be regarded as the most promising anti-thrombotic agent for diabetic patients with ACS. This agent may replace clopidogrel - and possibly GP IIb/IIIa inhibitors - in the future. In addition to aggressive anti-thrombotic therapy, diabetic patients should undergo systematic early invasive angiography if presenting with non-ST-segment elevation ACS, and immediate percutaneous coronary intervention if presenting with ST-segment elevation myocardial infarction. Indeed, the benefit derived from these strategies appears to be more pronounced in the diabetic population than in non-diabetic individuals. Despite the benefit, multiple surveys have demonstrated that, in the setting of ACS, diabetic patients receive evidence-based therapy less frequently than non-diabetic counterparts.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Eberli, Franz |
ISSN: |
1521-690X |
ISBN: |
19520305 |
Publisher: |
Baillière Tindall |
Language: |
English |
Submitter: |
Factscience Import |
Date Deposited: |
04 Oct 2013 15:09 |
Last Modified: |
05 Dec 2022 14:21 |
Publisher DOI: |
10.1016/j.beem.2009.01.003 |
PubMed ID: |
19520305 |
Web of Science ID: |
000267970000003 |
URI: |
https://boris.unibe.ch/id/eprint/30243 (FactScience: 191559) |
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