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Diabetes and Atherosclerosis

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Diabetes and Cardiovascular Disease

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Macrovascular disease is the leading cause of mortality and morbidity in diabetes. The study of factors that may uniquely contribute to the accelerated development of atherosclerosis in diabetes has been an ongoing process for several years. However, the concepts behind both the pathogenic mechanisms of atherosclerosis and the trigger mechanisms that lead to acute clinical events have drastically changed in the last two decades. It is now fully accepted that arteriosclerosis is a chronic inflammatory process and not a degenerative process that inevitably progresses with age. Also accepted is the fact that plaque rupture or erosion not the degree of vessel obstruction is responsible for the majority of acute cardiovascular events. Diabetes most likely contributes to and enhances the chronic inflammatory process characteristic of arteriosclerosis and supporting this concept are the studies showing that atherectomy specimens from diabetic patients undergoing coronary atherectomy for symptomatic coronary artery disease (CAD) have a larger content of macrophages than specimens from patients without diabetes (1). In recent years, mechanisms that lead to plaque formation and to plaque erosion or rupture and the key event that precedes both, endothelial dysfunction, are being actively studied (Fig. 1).

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Medical Genetics, Department of Medicine, Medical University of South Carolina, USA

    Maria F. Lopes-Virella MD, PhD

  2. Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC

    Maria F. Lopes-Virella MD, PhD

  3. Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC

    Gabriel Virella MD, PhD

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  1. Maria F. Lopes-Virella MD, PhD
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  2. Gabriel Virella MD, PhD
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Editors and Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

    Michael T. Johnstone MD, CM, FRCP(C)  & Aristidis Veves MD, DSC  & 

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Lopes-Virella, M.F., Virella, G. (2005). Diabetes and Atherosclerosis. In: Johnstone, M.T., Veves, A. (eds) Diabetes and Cardiovascular Disease. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-908-7:225

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  • DOI: https://doi.org/10.1385/1-59259-908-7:225

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