Revascularization in complex multivessel coronary artery disease after FREEDOM. Is there an indication for PCI and drug-eluting stents?

Koskinas, Konstantinos; Windecker, Stephan (2016). Revascularization in complex multivessel coronary artery disease after FREEDOM. Is there an indication for PCI and drug-eluting stents? Herz, 41(3), pp. 224-232. Springer-Medizin-Verlag 10.1007/s00059-016-4418-4

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Diabetes mellitus is a highly prevalent metabolic disorder frequently associated with the development of coronary atherosclerosis. Myocardial revascularization assumes a central role in the treatment of diabetic patients with coronary artery disease. Although coronary artery bypass grafting (CABG) is in principle the revascularization modality of choice in diabetic patients with complex, multivessel disease, percutaneous coronary interventions (PCI) using new-generation drug-eluting stents (DES) remain a valuable treatment option for properly selected diabetic patients. Defining the appropriate revascularization strategy is often a challenging task that requires tailored approaches, accounting for individual patient surgical risk, anatomical configurations, and the technical feasibility of each procedure in addition to careful judgment of the possible benefits and risks inherent to PCI and CABG. Evidence is building that advances in DES technology may mitigate at least in part some of the adverse vascular effects of diabetes; whether this may translate to PCI outcomes comparable with those achieved by CABG is under investigation in randomized trials currently underway. This review article summarizes the indications for myocardial revascularization across the spectrum of clinical presentations and critically discusses current evidence and future perspectives regarding the value of each revascularization mode (CABG vs. PCI) in patients with diabetes.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Koskinas, Konstantinos and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-9937

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Judith Liniger

Date Deposited:

29 Dec 2016 08:58

Last Modified:

24 Sep 2017 11:21

Publisher DOI:

10.1007/s00059-016-4418-4

PubMed ID:

27048841

Uncontrolled Keywords:

Coronary artery bypass grafting; Coronary artery disease; Diabetes mellitus; Myocardial revascularization; Percutaneous coronary interventions

BORIS DOI:

10.7892/boris.90025

URI:

https://boris.unibe.ch/id/eprint/90025

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