acs in diabetes - Currently the American Diabetes Association recommends cystic fibrosis and diabetes life expectancy the use of clopidogrel in very highrisk DM patients or as an alternative therapy in patients intolerant to aspirin 90 In line with this current guidelines recommend dual antiplatelet therapy with aspirin and clopidogrel as the antiplatelet treatment of choice for patients with ACS For patients with diabetes presenting with an acute ACS guidelines recommend an early invasive strategy as opposed to an initial conservative approach Apart from ensuring effective glycemic control guidelines largely recommend that patients with and without diabetes be treated similarly Accordingly dual antiplatelet therapy is the standard Atypical presentation of acute and chronic coronary artery disease in Hyperglycemia and Acute Coronary Syndrome Circulation AHAASA Journals Patients with diabetes have been shown to benefit to a greater extent than nondiabetic patients from the use of βblockers in the immediate postmyocardial infarction period 49 However our results confirm prior reports that fewer diabetic patients with an ACS are treated with βblocking agents than nondiabetic patients with an ACS 8914 Implications of Diabetes in Patients With Acute Coronary Syndromes Diabetes more common in nonpain ACS 35 vs 26 P 001 Shortness of breath most common in the painless presentation group 72 and women were more likely to have painless ACS 53 P 0007 Vaccarino et al 384878 patients Prospective observational study National Registry of MIUnited States 33 Within the context that diabetic patients may require a more aggressive antithrombotic regimen in the Clopidogrel in Unstable Angina to Prevent Recurrent Events CURE trial of subjects with ACS the point estimate of benefit for the diabetic subgroup with clopidogrel was only 15 compared with 20 overall 6 In the Optimizing Antiplatelet Therapy in Diabetes Mellitus OPTIMUS trial Acute Coronary Syndromes and Diabetes Mellitus Circulation Diabetes and Antiplatelet Therapy luka melepuh diabetes in Acute Coronary Syndrome Diabetes exacerbates the progression of atherosclerosis and is associated with increased risk of developing acute coronary syndrome ACS Approximatively 2530 of patients admitted for ACS have diabetes ACS occurs earlier in diabetics and is associated with increased mortality and a higher risk of recurrent ischemic events Acute coronary syndromes in diabetic patients outcome Management of Acute Coronary Syndromes in Patients with Diabetes Type 2 diabetes mellitus T2DM and its complications are seriously affecting public health worldwide Myocardial infarction MI is the primary cause of death in patients with T2DM The benefits of statins in preventing morbidity and mortality in patients with ACS have been validated in several clinical trials and the clinical decision to Hyperglycemia is common and associated with markedly increased mortality rates in patients hospitalized with acute coronary syndromes ACS Despite the fact that several studies have documented this association hyperglycemia remains underappreciated as a risk factor and it is frequently untreated in ACS patients This is in large part due to limitations of prior studies and the remaining The global prevalence of diabetes mellitus DM has led to a pandemic with significant microvascular and macrovascular complications including coronary artery disease CAD which worsen clinical outcomes and cardiovascular prognosis However ACS presentation and diagnosis among these patients remains challenging despite the achieved Diabetes mellitus and acute coronary syndrome lessons from PubMed Type 2 Diabetes and Myocardial Infarction Recent Clinical Evidence and Diabetes mellitus is a major independent risk factor for acute coronary syndrome ACS In addition diabetic patients with ACS suffer from increased mortality compared to their nondiabetic peers Driven by multiple pathophysiological disturbances such patients are predisposed to a proinflammatory prothrombotic state which may lead to plaque Diabetes Mellitus in gestasional diabetes etiologi pdf Acute Coronary Syndrome PMC
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