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Comparison of bypass surgery with drug‐eluting stents for diabetic patients with multivessel disease
- Source :
- International Journal of Cardiology. 123:34-42
- Publication Year :
- 2007
- Publisher :
- Elsevier BV, 2007.
-
Abstract
- Background This retrospective study of prospectively collected data compared coronary artery bypass graft (CABG) surgery to drug‐eluting stenting (DES) in diabetic patients with multivessel coronary artery disease (CAD). Prior randomized trials and clinical studies have suggested that CABG may be the preferred revascularization strategy in diabetic patients with multivessel CAD. Data are limited regarding the impact of DES vs. CABG on clinical outcomes. Methods We included 205 consecutive diabetic patients who underwent either CABG ( n =103) or DES ( n =102). The primary clinical end points were freedom from major adverse cardiac events (MACE) at 30 days and 1 year. Results Baseline characteristics were similar between both groups. At 1 year, the mortality rate was similar in the CABG and DES group (8% vs. 10%, p =0.6) but the MACE rate was lower in the CABG group (12% vs. 27%, p =0.006) due to less repeat revascularization with CABG (3% vs. 20%, p p =0.04). Angiographically‐documented stent thrombosis after DES occurred in 3%. Presentation with acute myocardial infarction (hazard ratio [HR], 2.26, 95% CI, 1.13 to 4.55) and DES (HR, 2.4, 95% CI, 1.23 to 4.77) were positive independent predictors, whereas therapy with a statin was a negative independent predictor of MACE (HR, 0.40, 95% CI, 0.21 to 0.76). Conclusions Bypass surgery was associated with less MACE primarily due to the higher repeat revascularization rate with DES and is therefore superior to DES despite more extensive CAD in CABG patients.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Paclitaxel
medicine.medical_treatment
Coronary Disease
Coronary Angiography
Revascularization
Coronary artery disease
Coronary artery bypass surgery
Coated Materials, Biocompatible
Internal medicine
medicine
Humans
cardiovascular diseases
Myocardial infarction
Coronary Artery Bypass
Aged
Retrospective Studies
Sirolimus
business.industry
Hazard ratio
medicine.disease
Antineoplastic Agents, Phytogenic
Surgery
Diabetes Mellitus, Type 1
Treatment Outcome
Diabetes Mellitus, Type 2
Bypass surgery
Drug-eluting stent
Cardiology
Female
Stents
Cardiology and Cardiovascular Medicine
business
Immunosuppressive Agents
Mace
Follow-Up Studies
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 123
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....fe37dbf011ecd3b3a7e749f8834abcbe