Percutaneous Coronary Intervention of Chronic Total Occlusions in Patients with Diabetes Mellitus: a Treatment-Risk Paradox

Current Cardiology Reports
Juan F IglesiasMarco Roffi

Abstract

Diabetes mellitus (DM) is highly prevalent among patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs). This review aims to summarize the available evidence on CTO recanalization in patients with DM. Coronary artery bypass grafting (CABG) surgery is the recommended revascularization modality for patients with DM and multivessel coronary artery disease (CAD). However, the optimal management strategy in diabetic patients with CTO and single-vessel disease or prior CABG remains a clinical dilemma. Contemporary, large-scale, observational registries support the notion that CTO PCI, if performed at high-volume CTO PCI centers by highly experienced operators, conveys similar high procedural success and low complication rates in patients with and without DM. Although DM patients have more frequently CTOs and may derive greater benefit from complete revascularization, they are less frequently exposed to CTO PCI than non-DM patients (treatment-risk paradox). CTO PCI performed by highly experienced operators constitutes a safe and effective treatment option for selected diabetic CTO patients who are not candidates for CABG. Randomized studies are warranted to compare long-term outcomes of CTO PC...Continue Reading

References

May 10, 2001·Journal of the American College of Cardiology·F LedruB Diébold
Jun 21, 2006·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·David M SafleySteven P Marso
Jul 19, 2008·Journal of the American College of Cardiology·Stephen J NichollsSteven E Nissen
Jun 23, 2009·JACC. Cardiovascular Interventions·J Aaron GranthamBarry D Rutherford
Aug 9, 2011·The American Journal of Cardiology·Bimmer E ClaessenUNKNOWN Multinational Cto Registry
Sep 7, 2011·European Heart Journal·Marco RoffiA Pieter Kappetein
Mar 10, 2012·Journal of the American College of Cardiology·Paul FeferBradley H Strauss
Apr 21, 2012·JACC. Cardiovascular Interventions·Emmanouil S BrilakisCraig A Thompson
Nov 6, 2012·The New England Journal of Medicine·Michael E FarkouhUNKNOWN FREEDOM Trial Investigators
Feb 16, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Arie Pieter KappeteinUNKNOWN SYNTAX Investigators
Mar 19, 2015·The American Journal of Cardiology·Georgios E ChristakopoulosEmmanouil S Brilakis
Apr 5, 2015·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Juan Ruiz-GarciaUNKNOWN CIBELES investigators
Apr 8, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Marco ZimarinoRaffaele De Caterina
Jan 1, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Maoto HabaraUNKNOWN Retrograde Summit Investigators
Aug 27, 2016·The American Journal of Cardiology·Lorenzo AzzaliniHung Q Ly
Nov 4, 2016·Diabetic Medicine : a Journal of the British Diabetic Association·J R Martinez-ParachiniE S Brilakis
Oct 30, 2016·Journal of the American College of Cardiology·Joren MaeremansJoseph Dens
Nov 29, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Francesca SanguinetiYves Louvard
Nov 11, 2017·JACC. Cardiovascular Interventions·Adam C SalisburyUNKNOWN OPEN CTO Study Group
Nov 11, 2017·JACC. Cardiovascular Interventions·Marco Roffi, Juan F Iglesias
Mar 20, 2018·JACC. Cardiovascular Interventions·Peter TajtiEmmanouil S Brilakis
Aug 31, 2018·European Heart Journal·Franz-Josef NeumannUNKNOWN ESC Scientific Document Group

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Citations

Jul 1, 2020·Expert Review of Cardiovascular Therapy·Ilias NikolakopoulosEmmanouil S Brilakis
May 1, 2021·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Salman BhatUmesh C Sharma

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