Glucose-lowering therapy in patients undergoing percutaneous coronary intervention

EuroIntervention. 2021 Oct 1;17(8):e618-e630. doi: 10.4244/EIJ-D-20-01250.

Abstract

The number of individuals with diabetes and pre-diabetes is constantly increasing. These conditions are overrepresented in patients undergoing percutaneous coronary intervention and are associated with adverse prognosis. Optimal glycaemic control during an acute coronary syndrome is a relevant factor for the improvement of longer-term outcomes. In addition, the implementation of newer glucose-lowering drugs with proven cardiovascular benefits has a remarkable impact on recurrence of events, hospitalisations for heart failure and mortality. In this narrative review, we outline the current state-of-the art recommendations for glucose-lowering therapy in patients with diabetes undergoing coronary intervention. In addition, we discuss the most recent evidence-based indications for revascularisation in patients with diabetes as well as the targets for glycaemic control post revascularisation. Current treatment goals for concomitant risk factor control are also addressed. Lastly, we acknowledge the presence of knowledge gaps in need of future research.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome* / drug therapy
  • Acute Coronary Syndrome* / surgery
  • Glucose
  • Glycemic Control
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Prediabetic State*

Substances

  • Glucose