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糖尿病患者的经皮冠状动脉介入治疗:支架的选择是否应受影响?

Percutaneous coronary intervention in diabetic patients: should choice of stents be influenced?

作者信息

Harskamp Ralf E, Park Duk-Woo

机构信息

Academic Medical Center, University of Amsterdam, The Netherlands.

出版信息

Expert Rev Cardiovasc Ther. 2013 May;11(5):541-53. doi: 10.1586/erc.13.38.

Abstract

Patients with diabetes mellitus are prone to a diffuse and rapidly progressive form of coronary artery disease. As a result, diabetic patients undergoing coronary revascularization are at higher risk of cardiovascular events compared with nondiabetic patients. Due to marked advances of stent device technology and adjunctive pharmacology, percutaneous coronary intervention has been regarded as an efficient revascularization strategy in diabetic patients. Numerous randomized trials and large observational registries have compared the efficacy and safety of bare-metal stents and drug-eluting stents, as well as several DE platforms. This article systematically reviews the cumulative evidence from key clinical studies and tries to help guide the physician in making informed decisions on the optimal stent type for patients with diabetes mellitus.

摘要

糖尿病患者易患弥漫性且进展迅速的冠状动脉疾病。因此,与非糖尿病患者相比,接受冠状动脉血运重建的糖尿病患者发生心血管事件的风险更高。由于支架装置技术和辅助药理学的显著进步,经皮冠状动脉介入治疗已被视为糖尿病患者有效的血运重建策略。众多随机试验和大型观察性注册研究比较了裸金属支架和药物洗脱支架以及几种药物洗脱平台的疗效和安全性。本文系统回顾了关键临床研究的累积证据,并试图帮助指导医生就糖尿病患者的最佳支架类型做出明智决策。

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