Study Explains Why Diabetics Face High Risk From Angioplasty
Why exactly the heart vessels in diabetic patients are more likely to clog is not clear. It may be related to something that happens to the cells of the heart vessel itself, or to more generalized factors -- or to both, Van Belle says.
"An answer to these questions may help to design new pharmacological approaches that hopefully should improve the outcome of this high risk group of patients," Van Belle tells WebMD.
In an editorial accompanying the report, Burton E. Sobel, MD, suggests that high levels of insulin in the blood of diabetics may affect clotting or the cells in the smooth wall of blood vessels that are involved in the clogging. In nondiabetics, the smooth muscle cells tend to grow back, while in diabetics a lot of excess material accumulates that can cause ruptures, he suggests.
Sobel is chair of the department of medicine at the University of Vermont School of Medicine in Burlington.
Experts say the new findings are likely to have an important effect on the way patients are treated because so many diabetics are candidates for angioplasty. While diabetics make up only 5% of the general population, they account for 15-25% of the candidates for angioplasty, according to the American Heart Association.
"The importance of this study is that it links the findings about restenosis to mortality," Sidney Smith, MD, chief science officer for the American Heart Association and professor of medicine at the University of North Carolina School of Medicine in Chapel Hill, tells WebMD. "This is a very interesting report that joins a growing body of evidence showing that diabetics who are treated with balloon angioplasty and who are not given the newer antiplatelet agents have a higher incidence of restenosis and do less well."
Smith is chair of a committee of the American Heart Association that is studying angioplasty in patients with diabetes.
He notes that in the U.S., 80% of all patients -- diabetic and nondiabetic -- already receive a stent to prevent restenosis. Like Van Belle, Smith says the use of anticlotting agents -- especially the drug abciximab-- can be extremely beneficial to diabetic patients receiving angioplasty.
Study Explains Why Diabetics Face High Risk From Angioplasty
Why exactly the heart vessels in diabetic patients are more likely to clog is not clear. It may be related to something that happens to the cells of the heart vessel itself, or to more generalized factors -- or to both, Van Belle says.
"An answer to these questions may help to design new pharmacological approaches that hopefully should improve the outcome of this high risk group of patients," Van Belle tells WebMD.
In an editorial accompanying the report, Burton E. Sobel, MD, suggests that high levels of insulin in the blood of diabetics may affect clotting or the cells in the smooth wall of blood vessels that are involved in the clogging. In nondiabetics, the smooth muscle cells tend to grow back, while in diabetics a lot of excess material accumulates that can cause ruptures, he suggests.
Sobel is chair of the department of medicine at the University of Vermont School of Medicine in Burlington.
Experts say the new findings are likely to have an important effect on the way patients are treated because so many diabetics are candidates for angioplasty. While diabetics make up only 5% of the general population, they account for 15-25% of the candidates for angioplasty, according to the American Heart Association.
"The importance of this study is that it links the findings about restenosis to mortality," Sidney Smith, MD, chief science officer for the American Heart Association and professor of medicine at the University of North Carolina School of Medicine in Chapel Hill, tells WebMD. "This is a very interesting report that joins a growing body of evidence showing that diabetics who are treated with balloon angioplasty and who are not given the newer antiplatelet agents have a higher incidence of restenosis and do less well."
Smith is chair of a committee of the American Heart Association that is studying angioplasty in patients with diabetes.
He notes that in the U.S., 80% of all patients -- diabetic and nondiabetic -- already receive a stent to prevent restenosis. Like Van Belle, Smith says the use of anticlotting agents -- especially the drug abciximab-- can be extremely beneficial to diabetic patients receiving angioplasty.
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