Comparison of Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention in Patients with Diabetes

Author:

Toklu Bora,Bangalore Sripal

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine

Reference68 articles.

1. Abdallah MS, Wang K, Magnuson EA, et al. Quality of life after PCI vs CABG among patients with diabetes and multivessel coronary artery disease: a randomized clinical trial. JAMA. 2013;310(15):1581–90.

2. Authors/Task Force M, Windecker S, Kolh P, et al. ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35(37):2541–619.

3. Bangalore S, Kumar S, Fusaro M, et al. Outcomes with various drug eluting or bare metal stents in patients with diabetes mellitus: mixed treatment comparison analysis of 22,844 patient years of follow-up from randomised trials. BMJ. 2012;345:e5170.

4. Bangalore S, Toklu B, Amoroso N, et al. Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. BMJ. 2013;347:f6625. A meta-analysis of 126 randomized controlled comparison trials of all available stents showed that 2nd generation DES, especially CoCr EES, is the most efficacious and safe stent in the current market even when compared to 1st generation DES.

5. Bangalore S, Toklu B, Feit F. Outcomes with coronary artery bypass graft surgery versus percutaneous coronary intervention for patients with diabetes mellitus: can newer generation drug-eluting stents bridge the gap? Circulation. Cardiovasc Interv. 2014;7(4):518–25. A mixed treatment analysis that included 68 randomized controlled trials enrolling 24015 diabetic patients and 71595 patient-years of follow-up revealed that the clinical efficacy gap between CABG and PCI has narrowed with newer generations of PCI modality as CABG was separately compared to POBA to BMS to 1st generation DES. Furthermore, an indirect analysis comparing CABG to 2nd generation DES, especially cobalt-chromium everolimus-eluting stent, showed similar outcomes in death and MI; CABG was associated with numerically increased stroke events whereas PCI with cobalt-chromium everolimus-eluting stent associated with numerically increased repeat revascularization.

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