Angioplasty Risks and Diabetes

[KMR__0]

  Can you please give me some information, or point me to some articles on
  the risks of angioplasty's to diabetics? I'm especially interested in the
  effects of the dye used in angio's on a diabetics kidneys.
  Thanks.
  -kmr
--------------------------------------------------------------------------------------------------------------------
Dear Ram,
Thank you for your question.  Here are some articles you may find useful.  Your local medical library can help you to find these.
Unique Identifier
96204801
Authors
Aronson D.  Bloomgarden Z.  Rayfield EJ.
Institution
Department of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
Title
Potential mechanisms promoting restenosis in diabetic patients. [Review] [103 refs]
Source
Journal of the American College of Cardiology.  27(3):528-35, 1996 Mar 1.
Local Messages
AVAILABLE IN CCF LIBRARY SERVICES DEPT.
MeSH Subject Headings
Angioplasty, Transluminal, Percutaneous Coronary/ae [Adverse Effects]
Coronary Disease/et [Etiology]
*Coronary Disease/pp [Physiopathology]
Coronary Disease/th [Therapy]
Diabetes Mellitus/co [Complications]
*Diabetes Mellitus/pp [Physiopathology]
Endothelium, Vascular/in [Injuries]
Endothelium, Vascular/pp [Physiopathology]
Growth Substances/ph [Physiology]
Human
Platelet Aggregation
Recurrence
Risk Factors
Abstract
Diabetes is associated with greater restenosis rates after successful balloon angioplasty. The metabolic alterations that occur as a result of hyperglycemia or hyperinsulinemia can accelerate many of the pathophysiologic processes that lead to restenosis. Diabetes results in endothelial dysfunction and accelerated platelet deposition, which increase the propensity to thrombosis. Several growth factors known to promote the restenosis process are overexpressed in the presence of hyperglycemia. Advanced glycosylation promotes inflammatory cell recruitment and smooth muscle cell proliferation. Many of the potential mechanisms promoting restenosis in diabetic patients can be ameliorated by improved metabolic control. [References: 103]
Unique Identifier
96392919
Authors
Raman M.  Nesto RW.
Institution
Cardiovascular Division, Deaconess Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Title
Heart disease in diabetes mellitus. [Review] [64 refs]
Source
Endocrinology & Metabolism Clinics of North America.  25(2):425-38, 1996 Jun.
Local Messages
AVAILABLE IN CCF LIBRARY SERVICES DEPT.
MeSH Subject Headings
Adrenergic beta-Antagonists/tu [Therapeutic Use]
Angioplasty, Transluminal, Percutaneous Coronary
Atherosclerosis/et [Etiology]
Atherosclerosis/pp [Physiopathology]
Coronary Artery Bypass
*Diabetes Mellitus/co [Complications]
Diabetes Mellitus/pp [Physiopathology]
Heart Diseases/ep [Epidemiology]
*Heart Diseases/et [Etiology]
Heart Diseases/pp [Physiopathology]
Heart Diseases/th [Therapy]
Heart Failure, Congestive/ep [Epidemiology]
Human
Myocardial Infarction/ep [Epidemiology]
Myocardial Infarction/th [Therapy]
Myocardial Ischemia/et [Etiology]
Thrombolytic Therapy
Abstract
The spectrum of heart disease in diabetic patients is broad and complex. This article discusses the epidemiologic associations between the two causes. It attempts to summarize the effects of diabetes at the cellular, vascular, and myocardial levels. The clinical manifestations are explored, and the treatment of heart disease as it pertains to diabetic patients is discussed. [References: 64]
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.