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The British Journal of Diabetes & Vascular Disease
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Review: The management of stable angina in diabetes

Ian L Williams

Department of Cardiology, Guy's, King's and St Thomas' School of Medicine, London, UK, ian.l.williams{at}kcl.ac.uk

Ali Vazir

Department of Cardiology, Guy's, King's and St Thomas' School of Medicine, London, UK

Azfar G Zaman

Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK

Cardiovascular atherosclerosis is the commonest underlying cause of death in patients with diabetes mellitus. The development of atherosclerosis is often accelerated and the outcome is worse in diabetic than non-diabetic patients. This may relate to abnormalities of platelet function, coagulation, blood pressure and lipid metabolism that are characteristic of diabetes. Management of angina in diabetes should focus on reducing symptoms and prolonging life. In both of these areas there are issues specific to the diabetic patient. The role of percutaneous and surgical approaches to coronary disease in diabetic patients continues to evolve and optimal therapy remains unclear. Herein explores the clinical management of coronary artery disease in patients with diabetes. The pathophysiological basis of stable and unstable coronary syndromes is explained and the effect of diabetes on coronary disease and its subsequent management is discussed.

Key Words: coronary heart disease • diabetes mellitus • myocardial infarction • thrombolysis • insulin regimen • revascularisation strategies.

References

  • Kannel WB, McGee DL Diabetes and cardiovascular disease. The Framingham study. JAMA 1979;241:2035-8.[Abstract/Free Full Text]
  • Ross R. Atherosclerosis - an inflammatory disease. N Engl J Med 1999; 340:115-26.[Free Full Text]
  • Stehouwer CD, Lambert J., Donker AJ, van Hinsbergh VW Endothelial dysfunction and pathogenesis of diabetic angiopathy. Cardiovasc Res 1997;34:55-68.[Abstract/Free Full Text]
  • Tooke JE Possible pathophysiological mechanisms for diabetic angiopathy in type 2 diabetes. J Diabetes Complications 2000;14:197-200.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Baumgartl HJ, Standl E. The atherosclerotic process and its exacerbation by diabetes. Exp Clin Endocrinol Diabetes 2001;109(suppl 2):S487-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hamm CW, Braunwald E. A classification of unstable angina revisited. Circulation 2000;102:118-22.[Abstract/Free Full Text]
  • Reeder GS Contemporary diagnosis and management of unstable angina. Mayo Clin Proc 2000;75:953-7.[Abstract]
  • el Khawand C., Jamart J., Donckier J. et al. Hemostasis variables in type 1 diabetic patients without demonstrable vascular complications. Diabetes Care 1993;16:1137-45.[Abstract]
  • Tschoepe D., Driesch E., Schwippert B., Nieuwenhuis HK, Gries FA Exposure of adhesion molecules on activated platelets in patients with newly diagnosed IDDM is not normalized by near-normoglycemia. Diabetes 1995;44:890-4.[Abstract]
  • Vinik AI, Erbas T., Park TS, Nolan R., Pittenger GL Platelet dysfunction in type 2 diabetes. Diabetes Care 2001;24:1476-85.[Abstract/Free Full Text]
  • Vicari AM, Macagni A. Primary platelet activation in recent-onset type 1 diabetes mellitus. Scand J Clin Lab Invest 1990;50:429-32.[Web of Science][Medline] [Order article via Infotrieve]
  • Sowers JR, Lester MA Diabetes and cardiovascular disease. Diabetes Care 1999;22(suppl 3):C14-20.[Web of Science][Medline] [Order article via Infotrieve]
  • Sowers JR Diabetes mellitus and cardiovascular disease in women. Arch Intern Med 1998;158:617-21.[Abstract/Free Full Text]
  • Ceriello A. Coagulation activation in diabetes mellitus: the role of hyperglycaemia and therapeutic prospects. Diabetologia 1993;36:1119-25.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Rao AK, Chouhan V., Chen X., Sun L., Boden G. Activation of the tissue factor pathway of blood coagulation during prolonged hyperglycemia in young healthy men. Diabetes 1999;48:1156-61.[Abstract]
  • Bastard JP, Pieroni L., Hainque B. Relationship between plasma plasminogen activator inhibitor 1 and insulin resistance. Diabetes Metab Res Rev 2000;16:192-201.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • McGill JB, Schneider DJ, Arfken CL, Lucore CL, Sobel BE Factors responsible for impaired fibrinolysis in obese subjects and NIDDM patients. Diabetes 1994;43:104-09.[Abstract]
  • Brownlee M., Vlassara H., Cerami A. Inhibition of heparin-catalyzed human antithrombin III activity by nonenzymatic glycosylation. Possible role in fibrin deposition in diabetes. Diabetes 1984;33:532-5.[Abstract]
  • Hypertension in Diabetes Study (HDS): II. Increased risk of cardiovascular complications in hypertensive type 2 diabetic patients. J Hypertens 1993; 11:319-25.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Turner RC, Millns H., Neil HA et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998;316:823-8.[Abstract/Free Full Text]
  • Sowers JR, Epstein M., Frohlich ED Diabetes, hypertension, and cardiovascular disease: an update. Hypertension 2001;37:1053-9.[Abstract/Free Full Text]
  • Gress TW, Nieto FJ, Shahar E., Wofford MR, Brancati FL Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000;342:905-12.[Abstract/Free Full Text]
  • Wierzbicki AS, Nimmo L., Feher MD, Cox A., Foxton J., Lant AF Association of angiotensin converting enzyme DD genotype with hypertension in diabetes. J Hum Hypertens 1995;9:671-3.[Web of Science][Medline] [Order article via Infotrieve]
  • Sobenin IA, Tertov VV, Orekhov AN Atherogenic modified LDL in diabetes. Diabetes 1996;45(suppl 3):S35-9.[Web of Science][Medline] [Order article via Infotrieve]
  • Galle J., Schneider R., Winner B. et al. Glyc-oxidized LDL impair endothelial function more potently than oxidized LDL: role of enhanced oxidative stress. Atherosclerosis 1998;138:65-77.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Tomkin GH, Owens D. Abnormalities in apo B-containing lipoproteins in diabetes and atherosclerosis. Diabetes Metab Res Rev 2001;17:27-43.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Dobrian A., Lazar V., Tirziu D., Simionescu M. Increased macrophage uptake of irreversibly glycated albumin modified-low density lipoproteins of normal and diabetic subjects is mediated by non-saturable mechanisms. Biochim Biophys Acta 1996;1317:5-14.[Medline] [Order article via Infotrieve]
  • Rubies-Prat J., Ordonez-Llanos J., Martin S. et al. Low-density lipoprotein particle size, triglyceride-rich lipoproteins, and glucose tolerance in non-diabetic men with essential hypertension. Clin Exp Hypertens 2001;23:489-500.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Betteridge DJ Diabetes, lipoprotein metabolism and atherosclerosis. Br Med Bull 1989;45:285-311.[Abstract/Free Full Text]
  • Howard BV Insulin resistance and lipid metabolism. Am J Cardiol 1999; 84:28J-32J.[Web of Science][Medline] [Order article via Infotrieve]
  • Lopez-Jimenez F., Goldman L., Johnson PA et al. Effect of diabetes mellitus on the presentation and triage of patients with acute chest pain without known coronary artery disease. Am J Med 1998;105:500-05.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Paillole C., Passa P., Paycha F. et al. Non-invasive identification of severe coronary artery disease in patients with long-standing diabetes mellitus. Eur J Med 1992;1:464-8.[Medline] [Order article via Infotrieve]
  • Salmasi AM, Abraham R., al-Kutoubi A., Nicolaides AN Exercise-induced inverted U wave in asymptomatic high-risk subjects. A preliminary study. Angiology 1994;45:789-95.[Medline] [Order article via Infotrieve]
  • Coisne D., Donal E., Torremocha F., Christiaens L., Allal J. Dobutamine stress echocardiography response of asymptomatic patients with diabetes. Echocardiography 2001;18:373-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Airaksinen KE Silent coronary artery disease in diabetes - a feature of autonomic neuropathy or accelerated atherosclerosis? Diabetologia 2001;44:259-66.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kondo T., Kubota I., Tachibana H., Yamaki M., Tomoike H. Glibenclamide attenuates peaked T wave in early phase of myocardial ischemia. Cardiovasc Res 1996;31:683-7.[Abstract/Free Full Text]
  • Lee DP, Fearon WF, Froelicher VF Clinical utility of the exercise ECG in patients with diabetes and chest pain. Chest 2001;119:1576-81.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kumar R., Patel CD, Marwah A., Gupta R., Sharma S., Malhotra A. Detection of coronary artery disease by stress thallium scintigraphy in diabetic patients. Nucl Med Commun 2001;22:287-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Machecourt J., Neuder Y., Halimi S., Ormezzano O., Fagret D., Vanzetto G. [Which coronary tests to use in asymptomatic diabetics?]. Arch Mal Coeur Vaiss 2000;93 Spec No 4:33-8.[Medline] [Order article via Infotrieve]
  • Elhendy A., van Domburg RT, Poldermans D. et al. Safety and feasibility of dobutamine-atropine stress echocardiography for the diagnosis of coronary artery disease in diabetic patients unable to perform an exercise stress test. Diabetes Care 1998;21:1797-802.[Abstract]
  • Scanlon PJ, Faxon DP, Audet AM et al. ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 1999;33: 1756-824.[Free Full Text]
  • Lindvall B., Brorsson B., Herlitz J., Albertsson P., Werko L. Comparison of diabetic and non-diabetic patients referred for coronary angiography. Int J Cardiol 1999;70:33-42.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • de Bono DP, Ravilious B., el-Zoubi I., Dyer T., Podinovskaya Y. A prioritisation system for elective coronary angiography. Heart 1998;79:448-53.[Abstract/Free Full Text]
  • Collaborative overview of randomised trials of antiplatelet therapy - I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration. BMJ 1994;308:81-106.[Abstract/Free Full Text]
  • Rolka DB, Fagot-Campagna A., Narayan KM Aspirin use among adults with diabetes: estimates from the Third National Health and Nutrition Examination Survey. Diabetes Care 2001;24:197-201.[Abstract/Free Full Text]
  • Sobol AB, Watala C. The role of platelets in diabetes-related vascular complications. Diabetes Res Clin Pract 2000;50:1-16.[Web of Science][Medline] [Order article via Infotrieve]
  • A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996;348:1329-39.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Mehta SR, Yusuf S. The Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) trial programme; rationale, design and baseline characteristics including a meta-analysis of the effects of thienopyridines in vascular disease. Eur Heart J 2000;21:2033-41.[Abstract/Free Full Text]
  • Yusuf S., Zhao F., Mehta SR, Chrolavicius S., Tognoni G., Fox KK Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001;345:494-502.[Abstract/Free Full Text]
  • Montalescot G. Value of antiplatelet therapy in preventing thrombotic events in generalized vascular disease. Clin Cardiol 2000;23(suppl 6):VI-18-22.
  • Kereiakes DJ Preferential benefit of platelet glycoprotein IIb/IIIa receptor blockade: specific considerations by device and disease state. Am J Cardiol 1998;81:49E-54E.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hansson L., Zanchetti A., Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet 1998;351:1755-62.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998;317:703-13.[Abstract/Free Full Text]
  • UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. BMJ 1998;317:713-20.[Abstract/Free Full Text]
  • Yusuf S., Sleight P., Pogue J., Bosch J., Davies R., Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000;342:145-53.[Abstract/Free Full Text]
  • Dahlof B., Devereux RB, Kjeldsen SE et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359:995-1003.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Lindholm LH, Ibsen H., Dahlof B. et al. Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002;359:1004-10.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Tatti P., Pahor M., Byington RP et al. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care 1998;21:597-603.[Abstract]
  • Joint British recommendations on prevention of coronary heart disease in clinical practice: summary. British Cardiac Society, British Hyperlipidaemia Association, British Hypertension Society, British Diabetic Association. BMJ 2000;320:705-08.[Free Full Text]
  • Yeo KR, Yeo WW Lipid lowering in patients with diabetes mellitus: what coronary heart disease risk threshold should be used? Heart 2002; 87:423-7.[Abstract/Free Full Text]
  • Randomised trial of cholesterol lowering in 4,444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Pyorala K., Pedersen TR, Kjekshus J., Faergeman O., Olsson AG, Thorgeirsson G. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care 1997;20:614-20.[Abstract]
  • Goldberg RB, Mellies MJ, Sacks FM et al. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the cholesterol and recurrent events (CARE) trial. The Care Investigators. Circulation 1998;98:2513-19.[Abstract/Free Full Text]
  • Coughlan BJ, Sorrentino MJ Does hypertriglyceridemia increase risk for CAD? Growing evidence suggests it plays a role. Postgrad Med 2000; 108:77-84.[Medline] [Order article via Infotrieve]
  • Koskinen P., Manttari M., Manninen V., Huttunen JK, Heinonen OP, Frick MH Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study. Diabetes Care 1992;15:820-5.[Abstract]
  • Albert MA, Danielson E., Rifai N., Ridker PM Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation/CRP evaluation (PRINCE): a randomized trial and cohort study. JAMA 2001;286:64-70.[Abstract/Free Full Text]
  • Sumi D., Hayashi T., Thakur NK et al. A HMG-CoA reductase inhibitor possesses a potent anti-atherosclerotic effect other than serum lipid lowering effects - the relevance of endothelial nitric oxide synthase and super-oxide anion scavenging action. Atherosclerosis 2001;155:347-57.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Feron O., Dessy C., Desager JP, Balligand JL Hydroxy-methylglutaryl-coenzyme A reductase inhibition promotes endothelial nitric oxide synthase activation through a decrease in caveolin abundance. Circulation 2001; 103:113-18.[Abstract/Free Full Text]
  • Ridker PM, Cushman M., Stampfer MJ, Tracy RP, Hennekens CH Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997;336:973-9.[Abstract/Free Full Text]
  • Lowel H., Koenig W., Engel S., Hormann A., Keil U. The impact of diabetes mellitus on survival after myocardial infarction: can it be modified by drug treatment? Results of a population-based myocardial infarction register follow-up study. Diabetologia 2000;43:218-26.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Gottlieb SS, McCarter RJ, Vogel RA Effect of beta-blockade on mortality among high-risk and low-risk patients after myocardial infarction. N Engl J Med 1998;339:489-97.[Abstract/Free Full Text]
  • Aronow WS, Ahn C. Effect of beta blockers on incidence of new coronary events in older persons with prior myocardial infarction and diabetes mellitus. Am J Cardiol 2001;87:780-1,A8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Estacio RO, Jeffers BW, Hiatt WR, Biggerstaff SL, Gifford N., Schrier RW The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med 1998;338:645-52.[Abstract/Free Full Text]
  • Zoccali C. Calcium channel blockers in diabetic subjects: innocent at last? Diabetes Nutr Metab 1999;12:249-51.[Web of Science][Medline] [Order article via Infotrieve]
  • Jansen R., Niemeyer MG, Cleophas TJ, Zwinderman AH Factors influencing efficacy of nitrate therapy for stable angina pectoris: a multiple linear regression analysis. Angiology 2000;51:1007-12.[Medline] [Order article via Infotrieve]
  • Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomised trial. Lancet 2002;359:1269-75.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Boes U., Wallner S., Wascher TC Acute effects of nicorandil on glucose tolerance in subjects with borderline fasting blood glucose levels. Wien Klin Wochenschr 2001;113:127-9.[Web of Science][Medline] [Order article via Infotrieve]
  • Dunn N., Freemantle S., Mann R. Nicorandil and diabetes: a nested case-control study to examine a signal generated by prescription-event monitoring. Eur J Clin Pharmacol 1999;55:159-62.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Brooks RC, Detre KM Clinical trials of revascularization therapy in diabetics. Curr Opin Cardiol 2000;15:287-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • King SB, 3rd, Mahmud E. Will blocking the platelet save the diabetic? Circulation 1999;100:2466-8.[Free Full Text]
  • Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. N Engl J Med 1996;335:217-25.[Abstract/Free Full Text]
  • King SB, Kosinski AS, Guyton RA, Lembo NJ, Weintraub WS Eight-year mortality in the Emory Angioplasty versus Surgery Trial (EAST). J Am Coll Cardiol 2000;35:1116-21.[Abstract/Free Full Text]
  • McGrath PD, Malenka DJ, Wennberg DE et al. Changing outcomes in percutaneous coronary interventions: a study of 34,752 procedures in northern New England, 1990 to 1997. Northern New England Cardiovascular Disease Study Group. J Am Coll Cardiol 1999;34:674-80.[Abstract/Free Full Text]
  • Serruys PW, Unger F., Sousa JE et al. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease. N Engl J Med 2001;344:1117-24.[Abstract/Free Full Text]
  • Marso SP, Lincoff AM, Ellis SG et al. Optimizing the percutaneous interventional outcomes for patients with diabetes mellitus: results of the EPISTENT (Evaluation of platelet IIb/IIIa inhibitor for stenting trial) diabetic substudy. Circulation 1999;100:2477-84.[Abstract/Free Full Text]
  • The ERASER Investigators. Acute platelet inhibition with abciximab does not reduce in-stent restenosis (ERASER study). Circulation 1999;100: 799-806.[Abstract/Free Full Text]
  • UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000;355:253-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • King SB, 3rd. Coronary artery bypass graft or percutaneous coronary interventions in patients with diabetes: another nail in the coffin or `too close to call?` J Am Coll Cardiol 2001;37:1016-18.[Free Full Text]
  • Kapur A., Malik IS Is surgery still the preferred option for coronary revascularisation in diabetics with multivessel coronary disease? Heart 2002; 87:407-09.[Free Full Text]

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 1, 18-25 (2003)
DOI: 10.1177/14746514030030010301


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