Author + information
- Received May 8, 1995
- Revision received September 13, 1995
- Accepted September 29, 1995
- Published online March 1, 1996.
- Doron Aronson, MD∗,
- Zachary Bloomgarden, MD and
- Elliot J. Rayfield, MD
- ↵∗Address for correspondence: Dr. Doron Aronson, Metabolism Section, Joslin Diabetes Center, One Joslin Place, Boston, Massachusetts 02215.
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.
- Received May 8, 1995.
- Revision received September 13, 1995.
- Accepted September 29, 1995.