Outcomes of Coronary Revascularization (Percutaneous or Bypass) in Patients With Diabetes Mellitus and Multivessel Coronary Disease

Hee, L.; Mussap, C.; Yang, Lihua; Dignan, Rebecca; Kadappu, K.; Juergens, C.; Thomas, Liza; French, John K.

doi:10.1016/j.amjcard.2012.04.043

Cited by 19 publications

(17 citation statements)

References 25 publications

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“…These results have been confirmed by other retrospective and cohort studies, both in the treatment of diabetic patients affected by multivessel CAD 10,12) or unprotected left main coronary artery. 11) It has been demonstrated that there is significantly increased durability of internal mammary grafts, with 90% patency rates reported at 20 years 21) with the use of bilateral mammary arteries in comparison to saphenous vein grafts.…”

Section: Considerations On Randomized Controlled Trialssupporting

confidence: 78%

“…8,9) On the other hand, other observational single-center or registry studies demonstrated that the diabetic cohort receiving PCI experienced worse results than the CABG cohort in terms of both safety and efficacy. [10][11][12][13] However, it is well known that retrospective studies provide a "real world" picture but their value is limited by the selection bias for treatment allocation related to their observational nature. Randomized controlled trials remain the benchmark for comparing the efficacy of both invasive treatments of these patients.…”

Section: Iabetes Mellitus (Dm) Is a Key Constituent Of The Meta-mentioning

confidence: 99%

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CABG Versus PCI in the Treatment of Diabetic Patients Affected by Coronary Artery Disease

Nicolini

Agostinelli²,

Vezzani³

et al. 2014

Int. Heart J.

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SummarySurgical coronary revascularization and percutaneous coronary intervention were demonstrated to be effective treatments for coronary artery disease. However, the optimal revascularization strategy remains unclear in certain patient subsets. The recently published Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM) trial is a randomized study evaluating the use of CABG versus PCI in diabetic patients with multivessel coronary disease. The purpose of this study was to review the available literature based on randomized trials and observational studies in order to allow clinicians to make evidence-based decisions when treating diabetic patients with multivessel coronary disease. The current evidence suggests that CABG should remain the standard of care for this patient population. (Int Heart J 2014; 55: 469-473)

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Section: Considerations On Randomized Controlled Trialssupporting

confidence: 78%

Section: Iabetes Mellitus (Dm) Is a Key Constituent Of The Meta-mentioning

confidence: 99%

CABG Versus PCI in the Treatment of Diabetic Patients Affected by Coronary Artery Disease

Nicolini

Agostinelli²,

Vezzani³

et al. 2014

Int. Heart J.

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“…10,23 Post-CABG atrial fibrillation is common and occurs in 30% to 50% of patients. 24 Similarly, atrial fibrillation can occur after PCI, albeit at a lower risk. The reported incidence of atrial fibrillation after PCI varies between 6.2% and 8.0% in patients undergoing primary PCI for myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Athappan

Chacko

Patvardhan

et al. 2014

Stroke

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Background and Purpose-Studies have suggested that the early excess risk of stroke in coronary artery bypass grafting (CABG) may be compensated for by a slow but progressive catch-up phenomenon in patients undergoing percutaneous coronary intervention (PCI). We therefore undertook this analysis to compare the temporal stroke risk between PCI and CABG in patients with unprotected left main stenosis and multivessel coronary artery disease. Methods-Studies of PCI versus CABG for unprotected left main stenosis and multivessel disease published between January 1994 (stent era) and July 2013 were identified using an electronic search and reviewed using meta-analytic techniques. Results-We selected 57 reports for the meta-analysis by applying the inclusion and exclusion criteria. The primary search terms used were CABG and PCI. For the Cochrane database the search terms were limited by the term clinical trial. Limiting the search parameters to the English language was applied subsequently. Citations were screened at the title and abstract level and retrieved as full reports if they were clinical studies, compared PCI with CABG, and provided information on the outcome of stroke. The full texts of all potential articles were reviewed in detail. The bibliography of retained studies was used to seek additional relevant studies. Inclusion CriteriaStudies were included if the following criteria applied: (1) comparative trials of CABG versus PCI with stent placement, (2) unprotected left main stenosis of >50% narrowing or multivessel disease, (3) a minimum of 30 patients, and (4) a minimum follow-up of 1 year. When 2 similar studies were reported from the same institution or author, the most recent publication was included in the analysis. Exclusion CriteriaStudies were excluded if any of the following criteria applied: (1) outcome of interest was not clearly reported or was impossible to extract or calculate from the published results, (2) <1-year follow-up, (3) included patients with ST-segment-elevation myocardial infarction, and (4) included patients with percutaneous transluminal coronary angioplasty without stents. Data ExtractionInformation collected included first author, year and journal of publication, study design, inclusion/exclusion criteria, definition of primary and secondary end points, number of subjects included, subjects undergoing PCI and CABG, percentage of drug-eluting stent used, study population demographics, number of diseased vessels, stenting technique, type of CABG (on pump versus off pump), left internal mammary artery graft used (single versus double), follow-up time period, rates of angiographic follow-up, antiplatelet regimen used, and primary and secondary outcomes. There was no disagreement between the 2 reviewers (G.A. and P.C.).

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“…16 They are being increasingly implemented for the treatment of multivessel complex coronary artery disease. 17 However, patients with ESRD are excluded from all randomized trials comparing various modalities of therapy of coronary artery disease. 18 We have demonstrated a distinct advantage for stents with regard to early mortality.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting Versus Drug-Eluting Stents in Patients with End-Stage Renal Disease

et al. 2014

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Outcomes of Coronary Revascularization (Percutaneous or Bypass) in Patients With Diabetes Mellitus and Multivessel Coronary Disease

Cited by 19 publications

References 25 publications

CABG Versus PCI in the Treatment of Diabetic Patients Affected by Coronary Artery Disease

CABG Versus PCI in the Treatment of Diabetic Patients Affected by Coronary Artery Disease

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Coronary Artery Bypass Grafting Versus Drug-Eluting Stents in Patients with End-Stage Renal Disease

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