Impact of diabetes on acute coronary syndrome management

Summary Diabetic patients with non-ST-segment elevation acute coronary syndromes (ACS) are at greater risk of subsequent cardiovascular events compared with nondiabetic counterparts. However, at the same time they derive greater benefit from aggressive antithrombotic therapy, early coronary angiography, and stent-based percutaneous coronary intervention. State-of-the-art antithrombotic therapy for diabetic patients with ACS include aspirin, clopidogrel, platelet glycoprotein IIb/IIIa receptor antagonists, and heparin or low-molecular-weight heparin. Both in the diabetic and nondiabetic population, drug-eluting stents lead to a dramatic reduction in restenosis. This exceptional therapeutic efficacy is expected to significantly improve the prognosis of diabetic patients with ACS.