Introduction

Diabetes mellitus (DM) is a major risk factor for accelerated atherosclerosis, is associated with a markedly increased prevalence of coronary artery disease (CAD), myocardial infarction (MI), and cardiac death, and is rapidly becoming a major public health concern in Western countries. The overall prevalence of CAD, as assessed by various invasive and noninvasive measures, is as high as 55% among adult patients with DM, compared with 2 to 4% for the general population. Diabetes mellitus also represents an independent risk factor for morbidity and mortality. The cardiovascular mortality rate has more than doubled in men and more than quadrupled in women with DM, compared to their counterparts without DM, and post-MI prognosis is also significantly worse in these patients.

Because diabetes is becoming such a common disease, diabetic patients account for a significant percentage of patients undergoing coronary revasculari- -o zation procedures; indeed, diabetics represent 15 to 25% of patients referred for |

percutaneous or surgical treatment of CAD. Importantly, DM is a recognized risk £

factor for adverse outcomes after either percutaneous coronary intervention (PCI) g or coronary artery bypass graft (CABG) surgery. <j

In particular, after coronary revascularization, short- and long-term outcomes in diabetic subjects are less favorable than in nondiabetic patients. In pa-

Diabetes Sustenance

Diabetes Sustenance

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