Revascularización coronaria en diabéticos: evidencias, indicaciones y complicaciones

In diabetic patients, coronary artery disease is very aggressive, with a high restenosis rate and rapidly progressive atherosclerosis. This document contains a review of the different forms and the effectiveness of the percutaneous treatment available for the diabetic population, ranging from the early days of balloon angioplasty to current techniques involving drug-eluting stents. Although restenosis may virtually be eradicated in he near future, concern about the safety of drug-eluting stents remains the main stumbling block to widespread implementation of the technique. Moreover, surgical coronary artery revascularization has been regarded as the gold standard for treating diabetics with multivessel disease. Ongoing randomized studies of surgery versus drug-eluting stent implantation will help determine the respective roles of the two techniques in providing revascularization therapy for these patients. Finally, if atherosclerotic disease progression is to be prevented in diabetic patients, both life-style modification and better metabolic control are essential.