Coronary artery disease (CAD) is the most common cause of death for patients with diabetes mellitus (DM). Patients with CAD
and DM constitute roughly one quarter of the total CAD population and are at increased risk of death compared to nondiabetic
patients, regardless of the clinical setting. As a consequence, aggressive use of medical and revascularization therapies
are appropriate for patients with DM given this increased risk.
Among patients with chronic stable CAD, patients with DM have been demonstrated to benefit from specific therapies, including
antiplatelet, renin-angiotensin-aldosterone system (RAAS) antagonists, aggressive blood pressure control, and aggressive lipid
management. In addition, attention to angina and evaluation of ischemic symptoms is important in the outpatient management
of the diabetic patient with CAD.
Presentation with Acute Coronary Syndromes (ACS) is currently characterized as ST Elevation Myocardial Infarction (STEMI),
and Unstable Angina or Non-ST Elevation MI (UA/NSTEMI). Specific characteristics of diabetic patients have been identified
among both ACS conditions, and particular benefits have been described from use of antiplatelet and anticoagulation therapies,
reperfusion therapy, administration of beta adrenergic and RAAS antagonists, lipid lowering therapy, and revascularization
techniques. In general, an aggressive approach to treatment of DM and CAD is recommended for both the stable and ACS populations.
Key words Coronary artery disease (CAD) - acute coronary syndrome (ACS) - myocardial infarction (MI) - coronary artery bypass grafting (CABG) - percutaneous coronary intervention (PCI)