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Diabetes Mellitus in Acute Coronary Syndrome
The global prevalence of diabetes mellitus (DM) has led to a pandemic, with significant microvascular and macrovascular complications including coronary artery disease (CAD), which worsen clinical outcomes and cardiovascular prognosis. Patients with both acute coronary syndrome (ACS) and DM have wor...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10671950/ https://www.ncbi.nlm.nih.gov/pubmed/38004366 http://dx.doi.org/10.3390/life13112226 |
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author | Stampouloglou, Panagiota K. Anastasiou, Artemis Bletsa, Evanthia Lygkoni, Stavroula Chouzouri, Flora Xenou, Maria Katsarou, Ourania Theofilis, Panagiotis Zisimos, Konstantinos Tousoulis, Dimitris Vavuranakis, Manolis Siasos, Gerasimos Oikonomou, Evangelos |
author_facet | Stampouloglou, Panagiota K. Anastasiou, Artemis Bletsa, Evanthia Lygkoni, Stavroula Chouzouri, Flora Xenou, Maria Katsarou, Ourania Theofilis, Panagiotis Zisimos, Konstantinos Tousoulis, Dimitris Vavuranakis, Manolis Siasos, Gerasimos Oikonomou, Evangelos |
author_sort | Stampouloglou, Panagiota K. |
collection | PubMed |
description | The global prevalence of diabetes mellitus (DM) has led to a pandemic, with significant microvascular and macrovascular complications including coronary artery disease (CAD), which worsen clinical outcomes and cardiovascular prognosis. Patients with both acute coronary syndrome (ACS) and DM have worse prognosis and several pathophysiologic mechanisms have been implicated including, insulin resistance, hyperglycemia, endothelial dysfunction, platelet activation and aggregations as well as plaque characteristics and extent of coronary lesions. Therefore, regarding reperfusion strategies in the more complex anatomies coronary artery bypass surgery may be the preferred therapeutic strategy over percutaneous coronary intervention while both hyperglycemia and hypoglycemia should be avoided with closed monitoring of glycemic status during the acute phase of myocardial infraction. However, the best treatment strategy remains undefined. Non-insulin therapies, due to the low risk of hypoglycemia concurrently with the multifactorial CV protective effects, may be proved to be the best treatment option in the future. Nevertheless, evidence for the beneficial effects of glucagon like peptide-1 receptor agonists, dipeptidyl-peptidase 4 inhibitors and sodium glycose cotransporter 2 inhibitors, despite accumulating, is not robust and future randomized control trials may provide more definitive data. |
format | Online Article Text |
id | pubmed-10671950 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106719502023-11-19 Diabetes Mellitus in Acute Coronary Syndrome Stampouloglou, Panagiota K. Anastasiou, Artemis Bletsa, Evanthia Lygkoni, Stavroula Chouzouri, Flora Xenou, Maria Katsarou, Ourania Theofilis, Panagiotis Zisimos, Konstantinos Tousoulis, Dimitris Vavuranakis, Manolis Siasos, Gerasimos Oikonomou, Evangelos Life (Basel) Review The global prevalence of diabetes mellitus (DM) has led to a pandemic, with significant microvascular and macrovascular complications including coronary artery disease (CAD), which worsen clinical outcomes and cardiovascular prognosis. Patients with both acute coronary syndrome (ACS) and DM have worse prognosis and several pathophysiologic mechanisms have been implicated including, insulin resistance, hyperglycemia, endothelial dysfunction, platelet activation and aggregations as well as plaque characteristics and extent of coronary lesions. Therefore, regarding reperfusion strategies in the more complex anatomies coronary artery bypass surgery may be the preferred therapeutic strategy over percutaneous coronary intervention while both hyperglycemia and hypoglycemia should be avoided with closed monitoring of glycemic status during the acute phase of myocardial infraction. However, the best treatment strategy remains undefined. Non-insulin therapies, due to the low risk of hypoglycemia concurrently with the multifactorial CV protective effects, may be proved to be the best treatment option in the future. Nevertheless, evidence for the beneficial effects of glucagon like peptide-1 receptor agonists, dipeptidyl-peptidase 4 inhibitors and sodium glycose cotransporter 2 inhibitors, despite accumulating, is not robust and future randomized control trials may provide more definitive data. MDPI 2023-11-19 /pmc/articles/PMC10671950/ /pubmed/38004366 http://dx.doi.org/10.3390/life13112226 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Stampouloglou, Panagiota K. Anastasiou, Artemis Bletsa, Evanthia Lygkoni, Stavroula Chouzouri, Flora Xenou, Maria Katsarou, Ourania Theofilis, Panagiotis Zisimos, Konstantinos Tousoulis, Dimitris Vavuranakis, Manolis Siasos, Gerasimos Oikonomou, Evangelos Diabetes Mellitus in Acute Coronary Syndrome |
title | Diabetes Mellitus in Acute Coronary Syndrome |
title_full | Diabetes Mellitus in Acute Coronary Syndrome |
title_fullStr | Diabetes Mellitus in Acute Coronary Syndrome |
title_full_unstemmed | Diabetes Mellitus in Acute Coronary Syndrome |
title_short | Diabetes Mellitus in Acute Coronary Syndrome |
title_sort | diabetes mellitus in acute coronary syndrome |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10671950/ https://www.ncbi.nlm.nih.gov/pubmed/38004366 http://dx.doi.org/10.3390/life13112226 |
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