Drug-Eluting Stents Compared With Bilateral Internal Thoracic Artery Grafts for Diabetic Patients

Moshkovitz, Yaron; Mohr, Rephael; Medalion, Benjamin; Hyam, Eytan; Herz, Itzhak; Deitch, Iris; Uretzky, Gideon; Pevni, Dmitry

doi:10.1016/j.athoracsur.2012.05.026

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…Finally, we included 18 studies yielding 17 532 patients who were assigned to DES implantation (n ¼ 8550) or to CABG (n ¼ 8982) in the present meta-analysis ( Figure 1). [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Mean follow-up period was 3.85 years. The main characteristics of the studies are presented in Table 1, and quality assessment results are summarized in Supplementary Tables 1 and 2.…”

Section: Eligible Studiesmentioning

confidence: 99%

Drug-Eluting Stent Versus Coronary Artery Bypass Grafting for Diabetic Patients With Multivessel and/or Left Main Coronary Artery Disease: A Meta-Analysis

et al. 2019

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With the development of stent design and surgical techniques, the relative benefit of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and complex coronary artery disease are highly debated. This meta-analysis was conducted to compare the outcomes of drug-eluting stent (DES) implantation and CABG in these cohorts. A comprehensive search of PubMed, Embase, and Cochrane Library up to January 4, 2018, was performed. Only randomized controlled trials (RCTs), subgroup analysis from RCTs, or adjusted observational studies were eligible. Five RCTs and 13 adjusted observational studies involving 17 532 patients were included. Overall, PCI with DES was significantly associated with higher risk of all-cause mortality (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 1.05-1.29), myocardial infarction (MI; HR: 1.69, 95% CI: 1.43-2.00), and repeat revascularization (HR: 3.77, 95% CI: 2.76-5.16) compared with CABG. Nevertheless, the risk of stroke was significantly lower in the DES group (HR: 0.67, 95% CI: 0.54-0.83). The incidence of the composite end point of death, MI, or stroke was comparable between the 2 groups (HR: 0.99, 95% CI: 0.84-1.17). Despite the higher risk of stroke, CABG was better than PCI with DES for diabetic patients with multivessel and/or left main coronary artery disease.

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Section: Eligible Studiesmentioning

confidence: 99%

Drug-Eluting Stent Versus Coronary Artery Bypass Grafting for Diabetic Patients With Multivessel and/or Left Main Coronary Artery Disease: A Meta-Analysis

et al. 2019

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“…5 Worse, the occurrence of stent thrombosis is elevated significantly with the presence of diabetes and coronary artery disease, thus markedly decreasing the benefit of PTCA in diabetic patients. 11,21 In spite of being more invasive, 18 Aronson et al, 45 noted that CABG possesses a greater freedom from reintervention for concomitant diabetic and MVD patients. Unfortunately, CABG harboured a higher risk of stroke Citation: Musa AF, Min CJ, Rahim AAA, et al Does percutaneous transluminal coronary angioplasty (PTCA) have comparable long-term outcomes compared to coronary artery bypass grafting (CABG) in diabetic patients?…”

Section: Discussionmentioning

confidence: 99%

Does percutaneous transluminal coronary angioplasty (PTCA) have comparable long-term outcomes compared to coronary artery bypass grafting (CABG) in diabetic patients?

Musa¹,

Min²,

Rahim³

et al. 2020

JDMDC

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onset diabetes of the young; LADA, latent autoimmune diabetes of adulthood; MI, myocardial infarction; LMSD, left main stem disease; MVD, multivessel disease; DES, drug eluting stent; RCS, randomised controlled trials; OS, observational studies; BARI, bypass angioplasty revascularization investigation; MACCE, major adverse cardiac and cerebrovascular events; EES, everolimus-eluting stent; ACR, hybrid coronary revascularization diabetes. 1 Compared to non-diabetic patients, the rate of mortality and adverse events in patients with diabetes is significantly higher. 2-4 Early revascularization could enhance their prognosis. 5 Nonetheless, the long-term merits of utilising either CABG or PTCA remains debatable. Aim Our study aims to investigate whether diabetic patients fare better in the long term with PTCA compared to CABG. Methods We conducted a literature search dating from January 2010 to June 2020 using PubMed, MEDLINE, Cochrane and Embase database to identify relevant articles. Medical Subject Heading (MeSH) terms such as "diabetes mellitus" "Percutaneous Transluminal Coronary Angioplasty" and "Coronary Artery Bypass Surgery" were used to identify journal articles. To allow additional relevant references selected, cross checking of references was also performed. We included studies that were (1) published from January 2010 to June 2020 with a (2) minimum duration of patient follow-up of five years regarding (3) revascularization of patients with Type 2 diabetes mellitus.

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“…We identified 19 eligible studies (4 randomized [19][20][21][22] and 15 nonrandomized [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]) ( Fig. 1) enrolling 5,805 patients in OCT subgroup (PCI-DES: 2,961; CABG: 2,844) and 3,060 in RCT subgroup (PCI-DES: 1,541; CABG: 1,519), respectively.…”

Section: Resultsmentioning

confidence: 99%

Comparison of bypass surgery and drug-eluting stenting in diabetic patients with left main and/or multivessel disease: A systematic review and meta-analysis of randomized and nonrandomized studies

et al. 2015

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Background: With advances in theinterventional field, the choice between coronary artery bypass grafting (CABG) and percutaneous coronary intervention with drug-eluting stents (PCI-DES) for the diabetic subset with left main (LM) and/or multivessel disease (MVD CABG (11.7% DES vs. 9.1% CABG, RR 1.23, p = 0. 06). Patients after PCI-DES had higher prevalence of myocardial infarction (MI) when compared with CABG (8.5% DES vs. 4.6% CABG, RR 1.68, p = 0.003). PCI-DES patients were at substantially lower risk of stroke (2.0% DES vs. 3.9% CABG, RR 0.51, p < 0.00001), but at several-fold higher risk of repeat revascularization (19.0% DES vs. 6.3% CABG, RR 2.95, p < 0.00001). The OCT patients risked a lower mortality as compared to the RCT patients (9.6% OCTs vs. 11.9% RCTs, RR 0.81, p = 0.001 (OCTs). (Cardiol J 2015; 22, 2: 123-134)

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Drug-Eluting Stents Compared With Bilateral Internal Thoracic Artery Grafts for Diabetic Patients

Cited by 19 publications

References 25 publications

Drug-Eluting Stent Versus Coronary Artery Bypass Grafting for Diabetic Patients With Multivessel and/or Left Main Coronary Artery Disease: A Meta-Analysis

Drug-Eluting Stent Versus Coronary Artery Bypass Grafting for Diabetic Patients With Multivessel and/or Left Main Coronary Artery Disease: A Meta-Analysis

Does percutaneous transluminal coronary angioplasty (PTCA) have comparable long-term outcomes compared to coronary artery bypass grafting (CABG) in diabetic patients?

Comparison of bypass surgery and drug-eluting stenting in diabetic patients with left main and/or multivessel disease: A systematic review and meta-analysis of randomized and nonrandomized studies

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