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Arora RR et al. – Data from CRUSADE suggests that the majority of patients are likely to benefit from aggressive upstream antithrombotic therapy. Patients with ACS who have diabetes have a higher risk for recurrent events than their nondiabetic counterparts but stand to benefit more from early aggressive therapy. Combining GP IIb/IIIa inhibition with drug–eluting stents offers the potential to optimize outcomes after revascularization in patients with diabetes. Whereas the use of drug–eluting stents has greatly reduced the risk of restenosis, patients with diabetes who have ACS and who undergo stenting remain at high risk for restenosis and are more likely to require revascularization. Increasing adherence to American College of Cardiology/American Heart Association guidelines is key to improving outcomes. The optimal management of patients with ACS continues to change as new therapies and strategies of care are developed and proven effective. The clinical challenge remains to increase physician adherence to evidence–based cardiac care for all patients.

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