PhD Defence Tobias Michiel Hommels

Keywords: Diabetes mellitus, Coronairlijden, Kwetsbare plaques, Bioresorbable scaffolds
 

"Challenges of Diabetes Mellitus and Percutaneous Treatment in Modern Interventional Cardiology"

Patients with diabetes mellitus develop more extensive coronary artery disease at a younger age than patients without this condition. This group of patients has both a reduced life expectancy as well as a reduced quality of life. A stenosis of the coronary artery may cause chest pain if it causes a lack of oxygen to the heart. Nowadays, invasive treatment, through means of percutaneous coronary intervention or coronary artery bypass graft surgery, mainly focuses on these stenoses. However, it appears that this type of stenosis could often be treated effectively with medication without shortening the lifespan. 

This thesis states that stenoses in the coronary arteries, which do not cause symptoms due to oxygen deficiency, may still carry dangerous characteristics. These characteristics cause an increased occurrence of myocardial infarctions or sudden cardiac death, especially in patients with diabetes mellitus. It therefore appears that the prospects of these patients are determined by other, more hidden characteristics of the coronary arteries. This finding stipulates the importance of utilising multiple diagnostic tools when assessing coronary artery disease to achieve a better risk stratification. 

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