Gestione multidisciplinare del paziente con sindrome coronarica acuta e diabete mellito: Dalla terapia antitrombotica al trattamento dell'iperglicemia

Translated title of the contribution: Multidisciplinary management of patients with acute coronary syndrome and diabetes mellitus: From antithrombotic therapy to the treatment of hyperglycemia

Roberta Rossini, Antonino Cimino, Stefano De Servi, Niccolò Grieco, Corrado Lettieri, Antonio Mafrici, Giuseppe Musumeci, Gianluca Perseghin, Carlo Sponzilli, Roberto Trevisan, Luigi Oltrona Visconti

Research output: Contribution to journalArticle

Abstract

Patients with diabetes mellitus (DM) and acute coronary syndromes (ACS) present a significantly higher risk of developing ischemic complications as compared to nondiabetic patients. Multiple mechanisms contribute to DM patients' enhanced prothrombotic status, including impaired fibrinolysis and coagulation, as well as endothelial and platelet dysfunction. Therefore, antithrombotic agents generally, and antiplatelet agents in particular, represent a logical secondary preventive strategy to reduce the risk of recurrent ischemic events in DM patients with ACS. However, DM patients often show attenuated responses to antiplatelet therapies for ACS patients. DM patients benefit from early coronary angiography and revascularization. Although randomized clinical trials have demonstrated that surgical revascularization is associated with an improved prognosis compared to percutaneous coronary intervention, a tailored revascularization strategy should be provided for each patient. The type of revascularization should be decided on the basis of SYNTAX score, surgical risk profile, and feasibility of total arterial revascularization in case of surgery. An accurate diagnosis and prompt treatment of hyperglycemia should also be provided for all patients. The present multidisciplinary document provides practical recommendations regarding diagnosis of DM and the management of hyperglycemia, from the acute phase to discharge. It is aimed at favoring early detection of hyperglycemia and identification of diabetic patients so as to provide adequate glucose control.

Translated title of the contributionMultidisciplinary management of patients with acute coronary syndrome and diabetes mellitus: From antithrombotic therapy to the treatment of hyperglycemia
Original languageItalian
Pages (from-to)378-392
Number of pages15
JournalGiornale Italiano di Cardiologia
Volume15
Issue number6
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Rossini, R., Cimino, A., De Servi, S., Grieco, N., Lettieri, C., Mafrici, A., Musumeci, G., Perseghin, G., Sponzilli, C., Trevisan, R., & Visconti, L. O. (2014). Gestione multidisciplinare del paziente con sindrome coronarica acuta e diabete mellito: Dalla terapia antitrombotica al trattamento dell'iperglicemia. Giornale Italiano di Cardiologia, 15(6), 378-392.