Comparación de los resultados clínicos a medio plazo de los stents farmacoactivos frente a la cirugía de revascularización coronaria en una población no seleccionada de pacientes diabéticos con afección multivaso. Análisis mediante propensity score

Domínguez-Franco, Antonio J.; Jiménez-Navarro, Manuel F.; Hernández-García, José M.; Alonso‐Briales, Juan H.; Linde-Estrella, Antonio L.; Pérez-González, Olga; Olalla-Mercadé, Eduardo; Teresa–Galván, Eduardo de

doi:10.1016/s0300-8932(09)71029-2

Cited by 15 publications

(1 citation statement)

References 31 publications

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“…Coronary artery disease (CAD) has been a critical issue that requires physicians to consider appropriate treatment strategies for elderly people who tend to have several comorbidities, including diabetes mellitus (DM), hypertension, and multivessel coronary disease (MVD) [2–5]. In the past few decades, several studies have been conducted comparing clinical outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) in patients with DM and MVD [6–8]. A recent large-scale randomized study demonstrated superior clinical outcomes in patients with DM and MVD who underwent CABG versus PCI with drug-eluting stents (DES) [9].…”

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confidence: 99%

Comparing mortality between coronary artery bypass grafting and percutaneous coronary intervention with drug-eluting stents in elderly with diabetes and multivessel coronary disease

et al. 2015

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Coronary artery disease is a critical issue that requires physicians to consider appropriate treatment strategies, especially for elderly people who tend to have several comorbidities, including diabetes mellitus (DM) and multivessel disease (MVD). Several studies have been conducted comparing clinical outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) in patients with DM and MVD. However, elderly people were excluded in those clinical studies. Therefore, there are no comparisons of clinical outcomes between CABG and PCI in elderly patients with DM and MVD. We compared all-cause mortality between PCI with drug-eluting stents (DES) and CABG in elderly patients with DM and MVD. A total of 483 (PCI; n = 256, CABG; n = 227) patients were analyzed. The median follow-up period was 1356 days (interquartile range of 810–1884). The all-cause mortality rate was not significantly different between CABG and PCI with DES groups. The CABG group had more patients with complex coronary lesions such as three-vessel disease or a left main trunk lesion. Older age, hemodialysis, and reduced LVEF were associated with increased long-term all-cause mortality in a multivariable Cox regression analysis. The rate of all-cause mortality was not significantly different between the PCI and CABG groups in elderly patients with DM and MVD in a single-center study.

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Section: Introductionmentioning

confidence: 99%

Comparing mortality between coronary artery bypass grafting and percutaneous coronary intervention with drug-eluting stents in elderly with diabetes and multivessel coronary disease

et al. 2015

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Meta-analysis of percutaneous coronary intervention versus coronary artery bypass graft surgery in patients with diabetes and left main and/or multivessel coronary artery disease

et al. 2012

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The optimal coronary revascularization strategy for patients with diabetes and left main and/or multivessel disease is undetermined. The aim of our study was to evaluate percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in those patients. We identified 13 articles, published before October 2011, enrolling 6992 patients, whose follow-up period ranged from 1 to 5 years. Patients with PCI had a significant reduction in cerebral vascular attack (CVA) (OR, 0.29; 95 % CI, 0.16-0.51; p < 0.0001, I (2) = 0 %) as compared with CABG, whereas there was a fourfold increased risk of repeat revascularization associated with PCI even using drug-eluting stent (OR, 4.44; 95 % CI, 3.42-5.78; Χ(2) = 4.92, p < 0.00001, I (2) = 0 %). The overall mortality (OR, 0.97; 95 % CI, 0.81-1.15; p = 0.70, I (2) = 0 %) was comparable between the PCI and CABG. However, in subgroup analysis, the composite outcome (death/myocardial infarction/CVA) was significantly reduced in favor of DES implantation (OR, 0.79; 95 % CI, 0.63-0.99; Χ(2) = 1.07, p = 0.04, I (2) = 0 %). Our study confirmed the cerebral vascular benefits of PCI by significantly reducing CVA risks, and the composite outcome was better in patients undergoing PCI with drug-eluting stent, despite a higher repeat revascularization rate. It poses imperative demands for future prospective randomized studies to define the optimal strategy in patients with diabetes and left main and/or multivessel disease.

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Impacto pronóstico de los síndromes geriátricos en pacientes con enfermedad coronaria multivaso que reciben revascularización percutánea

et al. 2018

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Comparación de los resultados clínicos a medio plazo de los stents farmacoactivos frente a la cirugía de revascularización coronaria en una población no seleccionada de pacientes diabéticos con afección multivaso. Análisis mediante propensity score

Cited by 15 publications

References 31 publications

Comparing mortality between coronary artery bypass grafting and percutaneous coronary intervention with drug-eluting stents in elderly with diabetes and multivessel coronary disease

Comparing mortality between coronary artery bypass grafting and percutaneous coronary intervention with drug-eluting stents in elderly with diabetes and multivessel coronary disease

Meta-analysis of percutaneous coronary intervention versus coronary artery bypass graft surgery in patients with diabetes and left main and/or multivessel coronary artery disease

Impacto pronóstico de los síndromes geriátricos en pacientes con enfermedad coronaria multivaso que reciben revascularización percutánea

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