@article{oai:niigata-u.repo.nii.ac.jp:00018851,
 author = {津田, 隆志 and 山口, 利夫 and 津田, 昌子 and 千葉, 泰子 and 矢田, 省吾 and 浜, 斉},
 issue = {12},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Dec},
 note = {Clinical and epidemiologic studies have shown an increased risk of coronary artery disease (CAD) among patients with diabetes mellitus (DM). Hyperglycemia has atherogenic action on the vessel wall due to several mechanisms, which include change of glycosylation and gene expression. Microalbuminuria is not only a prediction of clinical nephropathy but also cardiovascular disease. Insulin resistance has another atherogenic action. Syndrome X is a status related to insulin resistance which includes hyperinsulinemia, impaired glucose tolerance (IGT), hypertension, hypertriglyceridemia and low HDL cholesteremia. Asymptomatic myocardial ischemia may be commoner in diabetic patients. Exercise testing showed a low exercise capacity in diabetic patients, but false positive rate is high. Dipyridamole loading thallium myocardial scintigraphy is highly sensitive in a detection of CAD in DM. Diabetic patients have more coronary artery disease than nondiabetics, but no more diffuse or inoperable disease. In medical treatment, the choice of drugs, must be determined by the severity of symptom, tolerance of specific side effects, likelihood of adverse effects and presence of coexisting disease. DM is a strong risk factor for restenosis after PTCA. Compared to non-diabetics, CABG mortality rate in diabetics is consistently higher. Acute myocardial infarction is a major complication of diabetes. In-hospital mortality is approximately doubled in three of four studies which described acute infarction in diabetics. We conclude that more early blood sugar and risk factor control in IGT is protection of cardiovascular disease.},
 pages = {887--890},
 title = {4)糖尿病と虚血性心疾患(シンポジウム 糖尿病研究の進歩と治療, 第498回新潟医学会)},
 volume = {108},
 year = {1994}
}