Skip to main content
SpringerLink
Log in

Coronary Intervention and Ischemic Cardioprotection in Diabetic Patients

  • Chapter
Pharmacotherapy of Diabetes: New Developments

  • 1397 Accesses

Keywords: Coronary angiography, percutaneous intervention (PCI), coronary bypass surgery (CABG), Testenosis, acute myocardial infarction, insulinglucose infusion.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Pyorala K, Laakso M, Uusitupa M. Diabetes and atherosclerosis: an epidemiologic view. Diabetes Metab Rev 1987;3:463–524.

    Article  PubMed  CAS  Google Scholar 

  2. Laskey WK, Selzer F, Vlacvhos HA, Johnston J, Jacobs A, King SB III, Holmes DR, Douglas J, Block P, Wilensky R, Williams DO, Detre K. Comparison of in-hospital and one-year outcomes in patients with and without diabetes mellitus undergoing percutaneous catheter intervention (form the National Heart, Lung and Blood Institute Dynamic Registry). Am J Cardiol 2002;90:1062–1067.

    Article  PubMed  Google Scholar 

  3. Sobel BE, Frye R, Detre KM. Burgeoning dilemmas in the management of diabetes and cardiovascular disease. Rationale for the Bypass Angioplasty Revascularization Investigation 2 D (BARI 2D) trial. Circulation 2003;107:636–642.

    Article  PubMed  Google Scholar 

  4. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997;349:1498–1504.

    Article  PubMed  CAS  Google Scholar 

  5. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Eng J Med 1998;339:229–234.

    Article  CAS  Google Scholar 

  6. Naghavi M, Falk E, Hecht HS, Jamieson MJ, Kaul S, Berman D, Fayad Z, Budoff MJ, Rumberger J, Naqvi TZ, Shaw LJ, Faergeman O, Cohn J, Bahr R, Koenig W, Demirovic J, Arking D, Herrera VL, Badimon J, Goldstein JA, Rudy Y, Airaksinen J, Schwartz RS, Riley WA, Mendes RA, Douglas P, Shah PK. From vulnerable plaque to vulnerable patient – part III: Executive summary of screening for heart attack prevention and education (SHAPE) task force report. Am J Cardiol 2006;98:2H–15H.

    Article  PubMed  Google Scholar 

  7. Falk E. Pathogenesis of atherosclerosis. J Am Coll Cardiol 2006:47:C7–C12.

    Article  PubMed  CAS  Google Scholar 

  8. Saely CH, Aczel S, Marte T, Langer P, Drexel H. Cardiovascular complications in type 2 diabetes mellitus depend on the coronary angiographic state rather than on the diabetic state. Diabetologia 2004;47:145–146.

    Article  PubMed  CAS  Google Scholar 

  9. Eberly LE, Cohen JD, Prineas R, Yang L. Multiple Risk Factor Intervention Trial Research Group. Impact of incident diabetes and incident nonfatal cardiovascular disease on 18-year mortality. Diabetes Care 2003;26:848–854.

    Article  PubMed  Google Scholar 

  10. Clouse ME, Chen J, Krumholz HM. Noninvasive screening for coronary artery disease with computed tomography is useful. Circulation 2006;113:125–146.

    Article  PubMed  Google Scholar 

  11. Kim WY, Danias PG, Stuber M, Flamm SD, Plein S, Nagel E, Langerak SE, Weber OM, Pedersen EM, Schmidt M, Botnar RM, Manning WJ. Coronary magnetic resonance angiography for detection of coronary stenosis. N Engl J Med 2001;345:1863–1869.

    Article  PubMed  CAS  Google Scholar 

  12. Purushothaman KR, Sanz J, Zias E, Fuster V, Moreno PR. Atherosclerosis neovascularisation and imaging. Curr Mol Med 2006;6:549–556.

    Article  PubMed  CAS  Google Scholar 

  13. Kim WY, Astrup AS, Stuber M, Tarnow L, Falk E, Botnar RM, Simonson C, Pietraszek L, Hansen PR, Manning WJ, Andersen NT, Parving HH. Subclinical coronary and aortic atherosclerosis detected by magnetic resonance imaging in type 1 diabetes with and without diabetic nephropathy. Circulation 2007;115:180–187.

    Article  Google Scholar 

  14. Johnsen SP, Videbaek J, Pedersen L, Steffensen R, Videbaek R, Niemann T, Nielsen TT, Sørensen HT. Survival trends among Danish patients undergoing coronary angiography for known or suspected ischemic heart disease: a population based follow up study, 1992–2000. Heart 2006;92:27–31.

    Article  PubMed  CAS  Google Scholar 

  15. Rodriguez A, Boullon F, Perez-Balino N, Paviotti C, Liprandi MI, Palacios IF. Argentina randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease (ERACI); in-hospital results and 1-year follow-up. J Am Coll Cardiol 1993;22:1060–1067.

    Article  PubMed  CAS  Google Scholar 

  16. King SB III, Lembo NJ, Weintraub WS, Kosonski AS, Barnhart HX, Kutner MH, Alazraki NP, Guyton RA, Zhao XQ. A randomized trial comparing coronary angioplasty with coronary bypass surgery. Emory Angioplasty versus Surgery Trial (EAST). N Engl J Med 1994;331:1044–1050.

    Article  PubMed  Google Scholar 

  17. First-year results of CABRI (Coronary Angioplasty versus Revascularization Investigation). CABRI Trial Participants. Lancet 1995;346:1179–1184.

    Google Scholar 

  18. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996;335:217–225.

    Article  Google Scholar 

  19. Serruys PW, Unger F, Sousa JE, Jatene A, Bonnier HJ. Schonberger JP, Buller N, Bonser R, van den Brand MJB, van Herwerden LA, Morel MA, van Hout BA,–The Arterial Revascularization Therapies Study Group. Comparison of coronary bypass surgery and stenting for the treatment of multivessel disease. N Engl J Med 2001;344:1117–1124.

    Article  PubMed  CAS  Google Scholar 

  20. Detre KM, Guo P, Holubkov R, Califf RM, Sopko G, Bach R, Brooks MM, Bourassa MG, Shemin RJ, Rosen AD, Krone RJ, Frye RL, Feit F. Coronary revascularization in diabetic patients: A comparison of the randomized and observational components of the bypass angioplasty revascularization investigation (BARI). Circulation 1999;99:633–640.

    PubMed  CAS  Google Scholar 

  21. Holmes DR Jr, Vlietstra RE, Smith HC, Vetrovec, GW, Kent KM, Cowley HJ, Faxon DP, Gruentzig AR, Kelsey SF, Detre KM. Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA Registry of the National Heart, Lung and Blood Institute. Am J Cardiol 1984;53:77C–81C.

    Article  PubMed  Google Scholar 

  22. Mak KH, Faxon DP. Clinical studies on coronary revascularization in patients with type 2 diabetes. Eur Heart J 2003;24:1087–1103.

    Article  PubMed  Google Scholar 

  23. Meheran R, Dangas GD, Kobayashi Y, Lansky AJ, Mintz GS, Aymong ED, Fahy M, Moses JW, Stone GW, Leon MB. Short- and long-term results after multivessel stenting in diabetic patients. Am J. Coll Cardiol 2004;43:1348–1154.

    Article  Google Scholar 

  24. Scheen AJ, Warzée F, Legard VMG. Drug-eluting stents: meta-analysis in diabetic patients. Eur Heart J 2004;25:2167–2176.

    Article  PubMed  Google Scholar 

  25. Sabaté M, Jiménez-Quevedo PJ, Angioolillo DJ, Gómez-Hospital JA, Alfonso F, Hernández-Antolin R, Goicolea J, Bañuelos C, Escaned J, Moreno R, Fernández C, Fernández-Abilés F, Macaya C. Randomized comparison of sirolimus-eluting stent versus standard stent for percutaneous coronary revascularization in diabetic patients (Diabetes Trial). Circulation 2005;112:2175–2183.

    Article  PubMed  CAS  Google Scholar 

  26. Stone GW, Ellis SG, Cox DA, Hermiller J, O'Shaughnessy C, Mann JT, Turco M, Caputo R, Bergin P, Greenberg J, Popma JJ, Russel ME. One-year clinical results with the slow-release, polymer based, paclitaxel-eluting taxus stent. The taxus-IV trial. Circulation 2004;109:1942–1947.

    Article  PubMed  CAS  Google Scholar 

  27. Nordmann AJ, Briel M, Bucher HC. Mortality in randomized controlled trials comparing drug-eluting vs bare metal stents in coronary artery disease: a meta-analysis. Eur Heart J 2006:27:2784–2814.

    Article  PubMed  CAS  Google Scholar 

  28. Kastrai A, Mehelli J, Pache J, Kaiser C, Valgimigli M, Kelbæk H, Menichelli M, Sabaté M, Suttorp MJ, Baumgart D, Seyfarth M, Pfisterer ME, Schörnig A. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 2007;356;1030–1039.

    Article  CAS  Google Scholar 

  29. Maisel WH. Unanswered questions – Drug-eluting stents and the risk of late thrombosis. N Engl J Med 2007;356:981–984.

    Article  PubMed  CAS  Google Scholar 

  30. Takagi T, Akasaka T, Yamamuro A, Honda Y, Hozumi T, Morioka S, Yoshida K. Troglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with non-insulin dependent diabetes mellitus. J Am Coll Cardiol 2000;36:1529–1535.

    Article  PubMed  CAS  Google Scholar 

  31. Fragmin and Fast Revascularisation during instability in Coronary artery disease (FRISCII) investigators. Invasive compared with non-invasive treatment, in unstable coronary-artery disease:FRISCII prospective randomised multicenter study. Lancet 1999; 354:708–715.

    Google Scholar 

  32. Fox KA, Pool-Wilson PA, Henderson RA, Clayton TC, Chamberlain Da, Show TR, et al. Interventional versus conservative treatment for patients with unstable angina or non-ST-elevation myocardial infarction; the British Heart Foundation RITA 3 randomised trial. Randomized Intervention Trial of unstable Angina. Lancet 2002;360:743–751.

    Article  PubMed  CAS  Google Scholar 

  33. Andersen HR, Nielsen TT, Rasmussen K, Thuesen L, Kelbaek H, Thayssen P, Abildgaard U, Pedersen F, Madsen JK, Grande P, Villadsen AB, Krusell LR, Haghfelt T, Lomholt P, Husted SE, Vigholt E, Kjaergaard HK, Mortensen LS. DANAMI-2 investigators. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med 2003;349:733–742.

    Article  PubMed  Google Scholar 

  34. Boersma E, and the (PCAT)-2 trialists collaborative group. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. Eur Heart J 2006;27:779–788.

    Article  PubMed  Google Scholar 

  35. Franklin K, Goldberg RJ, Spencer F, Klein W, Budaj A, Brieger D, Marre M, Steg PG, Gowda N, Gore JM. GRACE investigators. Implications of diabetes in patients with acute coronary syndromes. The global Registry of Acute Coronary Events. Arch Intern Med 2004;164:1457–1463.

    Article  PubMed  Google Scholar 

  36. Norhammer A, Malmberg K, Diderholm E, Lagerqvist B, Lindahl B, Rydén L, Wallentin L. Diabetes mellitus: The major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J Am Coll Cardiol 2004;43:585–591.

    Article  Google Scholar 

  37. Henriques JPS, Zijlstra F, van't Hof AWJ, de Boer MJ, Dambrink JHE, Gosselink ATM, Hoorntje JCA, Ottervang JP, Suryapranata H. Primary percutaneous coronary intervention versus thrombolytic treatment: long term follow up according to infarct location. Heart 2006;92:75–79.

    Article  PubMed  CAS  Google Scholar 

  38. Hsu LF, Mak KH, Lau KW, Sim LL, Chan C, Koh TH, Chiah SC, Kam R, Ding ZP, Teo WS, Lim YL. Clinical outcomes of patients with diabetes mellitus and acute myocardial infarction treated with primary angioplasty or fibrinolysis. Heart 200;88:260–265.

    Google Scholar 

  39. Madsen MM, Busk M, Søndergaard HM, Bottcher M, Mortensen LS, Andersen HR, Nielsen TT. DANAMI-2 investigators. Does diabetes mellitus abolish the beneficial effect of primary coronary angioplasty on long-term risk of reinfarction after acute ST-segment elevation myocardial infarction compared with fibrinolysis? Am J Cardiol 2005;96:1469–1475.

    Article  PubMed  Google Scholar 

  40. Busk M, Mortensen LS, Thuesen L, Andersen HR, Rasmussen K, Madsen JK, Nielsen TT. Reinfarction after anterior ST-elevation myocardial infarction: initial benefit of primary angioplasty compared to fibrinolysis is lost during long-term follow up. Circulation 2005;112(Suppl. II):569.

    Google Scholar 

  41. Cutlip DE, Chhabra AG, Baim DS, Chauhan MS, Marulkar S, Massaro J, Bakhai A, Cohen DJ, Kuntz RE, Ho KK. Beyond restenosis. Five-year clinical outcome from second-generation coronary stent trials. Circulation 2004;110:1226–230.

    Article  PubMed  Google Scholar 

  42. Colwell JA, Nesto RW. The platelet in diabetes: focus on prevention of ischemic event. Diabetes care 2003;26:2181–2188.

    Article  PubMed  Google Scholar 

  43. Marso SP, Lincoff M, Elklis SG, Bhatt DL, Tanguay JF, Kleiman NS, Hammoud T, Booth JE, Sapp SK, Topol EJ. Optimizing the percutaneous interventional outcomes for patients with diabetes. Results from the Epistent Diabetic Substudy. Circulation 1999;100:2477–2484.

    PubMed  CAS  Google Scholar 

  44. Roffi M, Chew DP, Mukherjee D, Bhatt DL, White JA, Heeschen C, Hamm CW, Moliterno DJ, Califf RM, White HD, Kleiman NS, Theroux P, Topol EJ. Platelet glycoprotein IIb/IIIa inhibitors reduce mortality in diabetic patients with non-ST-segment-elevation acute coronary syndromes. Circulation 2001;104:2767–2771.

    Article  PubMed  CAS  Google Scholar 

  45. Mehilli J, Kastrati A, Schuhlen H, Dibra A, Dotzer F, von Beckerath N, Bollwein H, Pache J, Dirschinger J, Berger PP, Schömig A. ISAR-SWEET Study Investigators. Randomized clinical trial of abciximab in diabetic patients undergoing elective percutaneous coronary intervention after treatment with a high loading dose of clopidogrel. Circulation 2004;110:3627–3635.

    Article  PubMed  CAS  Google Scholar 

  46. Biondi-Zoccai GG, Abbate A, Liuzzo G, Biasucci LN. Atherothrombosis, inflammation, and diabetes. J Am Coll Cardiol 2003;41:1071–1077.

    Article  PubMed  CAS  Google Scholar 

  47. The APEX AMI investigators. Pexelizumab for acute ST-elevation myocardial infarction in patients undergoing primary percutaneous coronary intervention. A randomized controlled trial. JAMA 2007;297:43–51.

    Article  Google Scholar 

  48. UKPDS Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–853.

    Article  Google Scholar 

  49. Stratton IM, Adler AI, Neil AW, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR, UKPDS Group. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35):prospective observational study. BMJ 2000;321:405–412.

    Article  PubMed  CAS  Google Scholar 

  50. DDCT/EDIC Study Research Group. Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus. N Engl J Med 2003;348:2294–2303.

    Article  Google Scholar 

  51. DDCT/EDIC Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005;353:2643–2653.

    Article  Google Scholar 

  52. Proactive investigators. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study(PROspective pioglitAzone Clinical Trial In macroVascular Events): A randomized controlled trial. Lancet 2005;366:1279–1289.

    Article  CAS  Google Scholar 

  53. Corpus RA, George PB, House JA, Dixon SR, Ajluni SC, Devlin WH, Timmis GC, Balasubramaniam M, O'Neill WW. Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II diabetic patients undergoing elective percutaneous coronary intervention. J Am Coll Cardiol 2004;43:8–14.

    Article  PubMed  Google Scholar 

  54. Mazeika P, Prasad N, Bui S, Seidelin PH. Predictors of angiographic restenosis after coronary intervention in patients with diabetes mellitus. Am Heart J 2003;145:1013–1021.

    Article  PubMed  Google Scholar 

  55. Iwakura K, Ito H, Ikushima M, Kawano S, Okamura A, Asano K, Kuroda T, Tanaka K, Masuyama T, Hori M, Fujii K. Association between hyperglycemia and the no-flow phenomenon in patients with acute myocardial infarction. J Am Coll Cardiol 2003;41:1–7.

    Article  PubMed  CAS  Google Scholar 

  56. Timmer JR, van der Horst ICC, de Luca G, Ottervanger JP, Hoorntje JCA, de Boer MJ, Suryapranata H, Dambrink JHE, Gosselink M, Zijlstra F, van't Hof AWJ. Comparison of myocardial perfusion after successful primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction with and without diabetes mellitus. Am J Cardiol 2005;95:1375–1377.

    Article  PubMed  Google Scholar 

  57. van der Horst ICC, Zijlstra F, van't Hof AWJ, Doggen CJM, de Boer MJ, Suryapranata H, Hoorntje JCA, Dambrink JHE, Gans ROB, Bilo HJG. Glucose-insulin potassium infusion in patients treated with primary angioplasty for acute myocardial infarction. The glucose-insulin-potassium study: a randomized study. J Am Coll Cardiol 2003;42:784–791.

    Article  PubMed  CAS  Google Scholar 

  58. Malmberg K, Rydén L, Wedel H, Birkeland K, Bootsma A, Dickstein K, Efendric S, Fisher M, Hamsten A, Herlitz J, Hildebrandt P, Macleod K, Laakso M, Torp-Pedersen C, Waldenström A. Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity. Eur Heart J 2005;26:650–661.

    Article  PubMed  CAS  Google Scholar 

  59. The CREATE-ECLA Trial Group Investigators. Effect of glucose-insulin-potassium infusion on mortality in patients with acute ST-segment elevation myocardial infarction. The Create-Ecla randomized controlled trial. JAMA 2005;293:437–446.

    Google Scholar 

  60. The task force on diabetes and cardiovascular diseases of the European Society of cardiologi (ESC) and of the European Association for the Study of Diabetes (EASD).Guidelines on diabetes, pre-diabetes, and cardiovascular Diseases: executive summary. Eur Heart J 2007;28:88–136.

    Google Scholar 

  61. van den Bergie G, Wouters P, Weekes F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin treatment in critically ill patients. N Engl J Med 2001;345:1359–1367.

    Article  Google Scholar 

  62. van der Voort PHJ, Feenstra RA, Bakkert AJ, de Heide L, Boerma C, van der Horst ICC. Intravenous glucose intake independently related to intensive care unit and hospital mortality: an argument for glucose toxicity in critically ill patients. Clinical Endocrinol 2006;64:141–145.

    Article  CAS  Google Scholar 

  63. Malmberg K, Norhammer A, Wedel H, Rydén L. Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the Diabetes and Insulin-Glucose infusion in Acute Myocardial Infarction (DIGAMI) Study. Circulation 1999;99:2626–2632.

    PubMed  CAS  Google Scholar 

  64. Pinto DS, Skolnick AH, Kirtane AJ, Murphy SA, Barron HV, Giugliano RP, Cannon CP, Braunwald E, Gibson CM (TIMI study group). U-shaped relationship of blood glucose with adverse outcomes among patients with ST- segment elevation myocardial infarction. J Am Coll Cardiol 2005;46:178–180.

    Article  PubMed  CAS  Google Scholar 

  65. Goyal A, Mahaffey KW, Garg J, Nicolau JC, Hochman JS, Weaver WD, Therous P, Oliveira GBF, Todaro TG, Mojcik CF, Armstrong PW, Ganger CB. Prognostic significance of the change in glucose level in the first 24 h after acute myocardial infarction: results from the CARDINAL study. Eur Heart J 2006;27:1289–1297.

    Article  PubMed  CAS  Google Scholar 

  66. Norhammer A, Tenerz Aa, Nilsson G, Hamsten A, Efrendíc S, Rydén L, Malmberg K. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet 2002;359:2140–2144.

    Article  Google Scholar 

  67. The DECODE Study Group Consequences of the new diagnostic criteria for Diabetes in older men and women. DECODE Study (Diabetes epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe). Diabetes Care 1999;22:1667–671.

    Google Scholar 

  68. Anselimo M, Bartnik M, Malmberg K, Rydén L. Management of coronary artery disease in patients with and without diabetes mellitus. Acute management reasonable but secondary prevention unacceptable poor: a report from the Euro Heart Survey on Diabetes and the heart. Eur J Cardiovasc Prev Rehabil 2007;14:28–36

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Aarhus University Hospital, Brendstrupgaardsvej, DK 8200, Aarhus, Denmark

    Torsten Toftegaard Nielsen

Authors
  1. Torsten Toftegaard Nielsen
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Aarhus University Hospital, Nørrebrogade 44, DK-8000, Aarhus, Denmark

    Carl Erik Mogensen MD

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Nielsen, T.T. (2007). Coronary Intervention and Ischemic Cardioprotection in Diabetic Patients. In: Mogensen, C.E. (eds) Pharmacotherapy of Diabetes: New Developments. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-69737-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-69737-6_17

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-69736-9

  • Online ISBN: 978-0-387-69737-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation