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European Heart Journal 2003 24(12):1087-1103; doi:10.1016/S0195-668X(03)00111-8
Copyright © 2003 by the European Society of Cardiology.
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Clinical studies on coronary revascularization in patients with type 2 diabetes

Koon-Hou Maka,* and David P. Faxonb

a Department of Cardiology, National Heart Centre, Singapore, Singapore
b Section of Cardiology, University of Chicago, 5841 S. Maryland Ave., Mail Code 6080, Rm. B608, Chicago, IL 60637-1643, USA

* Corresponding author: Koon-Hou Mak, MBBS, FESC, Department of Cardiology, National Heart Centre, 17 Third Hospital Avenue, Singapore 168752. Tel.: +65-6436-7545; fax: +65-6227-3562
E-mail address: mak_koon_hou{at}nhc.com.sg

Received 10 October 2002; revised 27 November 2002; accepted 6 December 2002

With the increasing prevalence, diabetes is rapidly growing into a global public health problem. Cardiovascular disease is a major consequence of this chronic condition, and a critical issue facing physicians worldwide today is choice of coronary revascularization procedures in treating these patients. Since the Bypass Angioplasty Revascularization Investigation (BARI) alert in 1995, there have been several reports on subgroup analysis of clinical trials and registries concerning revascularization among patients with diabetes. Although randomized control studies comparing percutaneous and surgical revascularization procedures in this high-risk group of patients are lacking, this article provides the background for the excess risk and reviews the findings of these investigations. Current strategies to improve outcomes in patients with diabetes undergoing coronary revascularization procedures are discussed.

Key Words: Angioplasty • Bypass • GP IIb/IIIa inhibitor • Stent


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