In addition, newly diagnosed diabetes as well as pre-diabetes at hospital admission for ACS is associated with a similarly adverse long-term prognosis to that of patients with previously known diabetes 5, 11, 12, 13, 14. A recent meta-analysis of randomised controlled trials (RCTs) and observational studies comparing post-PCI outcomes showed a twofold increase of in-hospital and short-term (<1 year post PCI) mortality in patients with diabetes 10. Moreover, hyperglycaemia in patients undergoing percutaneous coronary intervention (PCI) is associated with adverse outcomes. Approximately 20-30% of patients with CAD have known diabetes, mainly T2DM, and many more (up to 70%) have newly detected diabetes or pre-diabetes when investigated with an oral glucose tolerance test (OGTT) 3, 4, 5, 6, 7, 8, 9. Glucose abnormalities are well established risk factors for coronary artery disease (CAD) 2, and they are considerably more common in patients with acute and chronic coronary syndromes (ACS, CCS) than in the general population. The prevalence of type 2 diabetes mellitus (T2DM) has been growing steadily in most countries 1. Lastly, we acknowledge the presence of knowledge gaps in need of future research. Current treatment goals for concomitant risk factor control are also addressed. 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. 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, 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. Optimal glycaemic control during an acute coronary syndrome is a relevant factor for the improvement of longer-term outcomes. These conditions are overrepresented in patients undergoing percutaneous coronary intervention and are associated with adverse prognosis. ![]() The number of individuals with diabetes and pre-diabetes is constantly increasing.
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