Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Mar 26, 2015; 7(3): 119-124
Published online Mar 26, 2015. doi: 10.4330/wjc.v7.i3.119
Coronary artery disease in type 2 diabetes mellitus: Recent treatment strategies and future perspectives
Ryo Naito, Takatoshi Kasai
Ryo Naito, Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
Takatoshi Kasai, Cardio-Respiratory Sleep Medicine, Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
Author contributions: All authors contributed equally to this editorial.
Conflict-of-interest: All of the authors declare no conflicts of interest related to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takatoshi Kasai, MD, Cardio-Respiratory Sleep Medicine, Department of Cardiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan. kasai-t@mx6.nisiq.net
Telephone: +81-3-38133111 Fax: +81-3-56890627
Received: December 3, 2014
Peer-review started: December 4, 2014
First decision: December 12, 2014
Revised: December 24, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: March 26, 2015
Processing time: 99 Days and 23.1 Hours
Abstract

Patients with type 2 diabetes mellitus (T2DM) are at a higher risk of developing coronary artery disease (CAD) than are non-T2DM patients. Moreover, the clinical outcomes in CAD with T2DM are poor despite improvements in medications and other interventions. Coronary artery bypass grafting is superior to percutaneous coronary intervention in treating multivessel coronary artery disease in diabetic patients. However, selecting a revascularization strategy depends not only on the lesion complexity but also on the patient’s medical history and comorbidities. Additionally, comprehensive risk management with medical and non-pharmacological therapies is important, as is confirmation regarding whether the risk-management strategies are being appropriately achieved. Furthermore, non-pharmacological interventions using exercise and diet during the earlier stages of glucose metabolism abnormalities, such as impaired glucose tolerance, might be beneficial in preventing the development or progression of T2DM and in reducing the occurrence of cardiovascular events.

Keywords: Diabetes; Comprehensive risk management; Multivessel disease; Drug-eluting stents; Percutaneous coronary intervention

Core tip: Clinical outcomes in coronary artery disease with type 2 diabetes mellitus (T2DM) are poor despite improvements in medications and other interventions. Although coronary artery bypass grafting is superior to percutaneous coronary intervention in multivessel coronary artery disease with T2DM, selecting the revascularization strategy depends not only on the lesion complexity but also on the patient’s medical history and comorbidities. In these patients, comprehensive risk management with medical and non-pharmacological therapies is indispensable, and confirming whether such risk management is being appropriately achieved is also important. Furthermore, interventions with exercise and diet therapy during the early stages of glucose abnormalities might be effective in preventing the development or progression of T2DM and in reducing the occurrence of cardiovascular events.