eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2017
vol. 14
 
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abstract:
Review paper

The impact of type 2 diabetes mellitus on prognosis in patients with non-ST elevation myocardial infarction

Katarzyna Birkner
,
Bartosz Hudzik
,
Mariusz Gąsior

Kardiochirugia i Torakochirurgia Polska 2017; 14 (2): 127-132
Online publish date: 2017/07/05
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Type 2 diabetes (T2D) is a recognized risk factor for acute coronary syndromes. There is currently no consensus concerning the intensification of antihyperglycemic treatment. According to the available guidelines, it seems that the goal is to achieve glycated hemoglobin (HbA1c) levels below 7% and avoid hypoglycemia. The choice of a revascularization method is influenced by many factors, such as the anatomy of the coronary arteries, severity of atherosclerosis, anatomical location of lesions, and presence of comorbidities. However, in non-ST elevation myocardial infarction, determining the culprit lesion is often difficult based on ECG or angiography. Experts recommend coronary artery bypass grafting (CABG) in patients with type 2 diabetes and multivessel or complex (SYNTAX score exceeding 22 points) coronary artery disease in order to improve survival. Percutaneous coronary intervention should be considered as an alternative to CABG to control symptoms in patients with type 2 diabetes and less complex forms of the disease (i.e., SYNTAX score of 22 or lower).
keywords:

type 2 diabetes mellitus, non-ST-elevation myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting

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