Diabetes can accelerate coronary artery disease and cause the vessels that supply blood to the heart to grow smaller and less elastic over time. As a result of this progression, the heart muscle may not receive enough blood flow.  When the heart does not receive enough blood flow, patients feel chest pain, heaviness, or tightness called “Angina”. 

Studies show that diabetics are more likely to feel Angina during daily activity than patients without diabetes¹.  The angina that these patients feel may not be the typical chest pain that is associated with angina.  It has been shown that diabetic patient’s angina symptoms are more often felt as hyperventilation, rather than aching or squeezing². As the coronary artery disease progresses and becomes unmanageable with cardiac medications, patients will be treated with angioplasty and stents or open heart coronary artery bypass surgery. Both procedures have excellent results, but diabetes increases the risk of these procedures as compared to the risk for non-diabetic patients³. In addition, diabetic patients are more likely to have recurrent angina after a bypass surgery than non-diabetic patients³.

The TMR procedure has been shown to reduce the risk of bypass operations⁴ and at 5 years follow up, 97% of diabetic patients that were treated with TMR in addition to bypass were angina free⁵. 

TMR has also been demonstrated to provide significant and sustained relief of angina and an increase in long term survival if bypass surgery is not an option⁶.

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1.        Falcone, C., Nespoli,, L., et al. Silent myocardial ischemia in diabetic and nondiabetic patients with coronary artery disease. Intl J Cardiology  2000;90: 219-227

2.        DeVon, H., Penckofer, S., et al. Symptoms of unstable angina in patients with and without diabetes. Res in Nurs & Health 2005;28:136-143

3.        Thourani, V.H., Weintraub, W.S., et, al. Influence of diabetes mellitus on early and late outcome after coronary artery bypass grafting. Ann Thorac Surg 1999;67: 1045-52

4.        Allen, K.B., DowlingR., DelRossi, A. et al . Transmyocardial laser revascularization combined with coronary artery bypass grafting: a multicenter, blinded, prospective, randomized, controlled trial. J Thorac Cardiovascular Surg 2000; 119:540-9

5.        Allen, K.B, Dowling, R., et al. Adjunctive Transmyocardial Revascularization: Five Year Follow up of a Prospective, Randomized Trial. Ann Throac Surg 2004;78:458-65

6.        Allen, K.B, Dowling, R., et al. Transmyocardial Revascularization: 5-year follow-up of a prospective, randomized multicenter trial. Ann Thorac Surg 2004; 77:1228-34