Diabetics at greatest risk of complications after re-opening arteries

DALLAS, March 6, 2001 Re-blocking of the artery a common complication after angioplasty is a more serious problem for people with diabetes than for non-diabetics, and could explain why they face an increased risk of death following the procedure, researchers report in todays Circulation: Journal of the American Heart Association.

Our study provides an explanation for the previous observation of the poor outcome of diabetic patients after coronary balloon angioplasty, says Eric Van Belle, M.D., an assistant professor at the University of Lille, France, and lead author of the study. It also suggests a new therapeutic target to improve the outcome of these patients.

Compared to the general population, people with diabetes fare worse following balloon angioplasty, in which a catheter tipped with a deflated balloon is inserted into a narrowed artery and the balloon is inflated to push open the clogged area and dilate the blood vessel. Van Belle says his study indicates that diabetics should be treated differently from the general population and may lead to new therapies to target re-blocking, or restenosis, in that group.

This suggests that balloon angioplasty alone must be abandoned in diabetic patients, he says. For this group of patients, using a stent a wire mesh tube implanted to prop open the artery reduces the incidence of restenosis following balloon angioplasty, although it still is higher than in non-diabetics who receive stents. In addition, Van Belle says stenting should be combined with powerful antiplatelet drugs for this high-risk group of patients.

The procedure, also known as percutaneous transluminal coronary angioplasty (PTCA), is a common alternative to bypass surgery for many patients. However, the increased death rate for diabetics which is four to five times higher than for non-diabetics over five years has led to questions about whether diabetics should undergo PCTA.

The study has great public health

Contact: Carole Bullock
American Heart Association

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