Lexis Chris P H, Rahel Braim M, Meeder Joan G, Zijlstra Felix, van der Horst Iwan C C
Department of Cardiology, VieCuri Medical Centre, Venlo, The Netherlands.
Cardiovasc Diabetol. 2009 Jul 28;8:41. doi: 10.1186/1475-2840-8-41.
The prevalence of diabetes is increasing rapidly, and individuals with diabetes are at high risk for cardiovascular disorders. Subsequently the percentage of patients with diabetes subjected to revascularisation, i.e. either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) also rises rapidly. The outcome of patients with diabetes after PCI is worse than for patients without diabetes. Restenosis is the main limiting factor of the long-term success of PCI. Although stents and antithrombotics improved outcome after PCI in both diabetics and non-diabetics, diabetics still have a worse prognosis. This leads to the suggestion that the restenosis mechanism in diabetics might be different from that in non-diabetics.
Several glucose lowering agents have been shown to influence the restenosis process and thus the outcome after PCI. Current data of especially metformin and thiazolidinediones indicate beneficial results as compared to insulin and sulfonylurea on restenosis. However, no large trials have been undertaken in which the effect of glucose lowering agents on restenosis is associated with improved outcome.The purpose of this review is to summarize the effect of diabetes and glucose lowering agents on restenosis.
糖尿病的患病率正在迅速上升，糖尿病患者患心血管疾病的风险很高。随后，接受血运重建（即经皮冠状动脉介入治疗（PCI）或冠状动脉旁路移植术（CABG））的糖尿病患者比例也迅速上升。PCI术后糖尿病患者的预后比非糖尿病患者差。再狭窄是PCI长期成功的主要限制因素。尽管支架和抗血栓药物改善了糖尿病患者和非糖尿病患者PCI后的预后，但糖尿病患者的预后仍然较差。这表明糖尿病患者的再狭窄机制可能与非糖尿病患者不同。
几种降糖药物已被证明会影响再狭窄过程，从而影响PCI后的预后。尤其是二甲双胍和噻唑烷二酮类药物的现有数据表明，与胰岛素和磺脲类药物相比，它们对再狭窄有有益效果。然而，尚未进行大型试验来研究降糖药物对再狭窄的影响与改善预后之间的关系。本综述的目的是总结糖尿病和降糖药物对再狭窄的影响。
