Abstract
BackgroundData regarding the long-term clinical outcomes in patients with insulin-treated type 2 diabetes mellitus (ITDM) revascularized by either coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) are still controversial. We sought to compare the long-term (≥1 year) adverse clinical outcomes in patients with ITDM who underwent revascularization by either CABG or PCI.MethodsRandomized Controlled Trials (RCTs) comparing the long-term clinical outcomes in patients with ITDM and non-ITDM revascularized by either CABG or PCI were searched from electronic databases. Data for patients with ITDM were carefully retrieved. Odd Ratio (OR) with 95 % confidence interval (CI) was used to express the pooled effect on discontinuous variables and the pooled analyses were performed with RevMan 5.3.ResultsSix RCTs involving 10 studies, with a total of 1297 patients with ITDM were analyzed (639 patients from the CABG group and 658 patients from the PCI group). CABG was associated with a significantly lower mortality rate compared to PCI with OR: 0.59, 95 % CI 0.42–0.85; P = 0.004. Major adverse cardiovascular and cerebrovascular events as well as repeated revascularization were also significantly lower in the CABG group with OR: 0.51, 95 % CI 0.27–0.99; P = 0.03 and OR 0.34, 95 % CI 0.24–0.49; P < 0.00001 respectively. However, compared to PCI, the rate of stroke was higher in the CABG group with OR: 1.41, 95 % CI 0.64–3.09; P = 0.40, but this result was not statistically significant.ConclusionCABG was associated with significantly lower long-term adverse clinical outcomes compared to PCI in patients with ITDM. However, due to an insignificantly higher rate of stroke in the CABG group, further researches with a larger number of randomized patients are required to completely solve this issue.
Highlights
Data regarding the long-term clinical outcomes in patients with insulin-treated type 2 diabetes melli‐ tus (ITDM) revascularized by either coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) are still controversial
Many studies have shown that revascularization performed using Coronary Artery Bypass Surgery (CABG) appears to be a better option compared to PCI in patients with Type 2 Diabetes mellitus (T2DM), in conditions such as multi-vessel Coronary Artery Disease (CAD), chronic total occlusion and so on
Earlier reports based on data from the CARDia (Coronary Artery Revascularization in Diabetes) trial [4] and the 5-year results of the SYNTAX trial [5] indicated significantly higher rates of Major Adverse Cardiovascular and Cerebrovascular Events (MACCEs) associated with PCI compared to CABG in patients with T2DM
Summary
Data regarding the long-term clinical outcomes in patients with insulin-treated type 2 diabetes melli‐ tus (ITDM) revascularized by either coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) are still controversial. Even if PCI is expected to be associated with worse clinical outcomes in patients with ITDM, data regarding the long-term adverse clinical outcomes in similar patients revascularized by either CABG or PCI are still controversial To further support this point, results from the FREEDOM trial showed no significant difference in the magnitude of CABG versus PCI treatment effect in patients with ITDM [2]. To solve this issue, we aim to compare the long-term adverse clinical outcomes in patients with ITDM revascularized by either CABG or PCI
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
