1. Revascularization strategies in patients with diabetes and stable ischemic heart disease: a systematic review and meta-analysis of randomized trials
- Author
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Hiroki Ueyama, Tomohiro Fujisaki, Hisato Takagi, Toshiki Kuno, and Masahiko Noguchi
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Ischemia ,Coronary Artery Disease ,Disease ,Revascularization ,law.invention ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,Humans ,Medicine ,In patient ,Coronary Artery Bypass ,Randomized Controlled Trials as Topic ,business.industry ,General Medicine ,medicine.disease ,Treatment Outcome ,Meta-analysis ,Cardiology and Cardiovascular Medicine ,business ,Ischemic heart - Abstract
The optimal treatment strategy comparing invasive revascularization versus optimal medical therapy (OMT) in patients with diabetes mellitus (DM) and stable ischemic heart disease (SIHD) still remains unclear. We aimed to investigate clinical outcomes of invasive revascularization (percutaneous coronary intervention, coronary artery bypass grafting or both) versus OMT in patients with DM and SIHD from updated published randomised-controlled trials (RCTs).We conducted a comprehensive literature search through PubMed and EMBASE to investigate the effect of revascularization versus OMT for patients with DM and SIHD. The studies were limited to RCTs or their subgroup data for a meta-analysis. The outcomes of interest were major adverse cardiovascular events (MACE) in patients with DM and SIHD.Our search identified subgroup data with DM of four RCTs including a total of 5742 patients with SIHD. Our results showed that invasive revascularization was not associated with a decreased risk of MACE when compared to OMT [hazard ratio (95% confidence interval): 0.95 (0.85-1.05), P = 0.31; I2 = 0%].Invasive revascularization was not associated with a decreased risk of MACE when compared with OMT.
- Published
- 2021