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Meta-analysis of studies comparing coronary artery bypass grafting with drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease.
Am J Cardiol. 2010 Jun 01; 105(11):1540-4.AJ

Abstract

This meta-analysis was undertaken to assess the efficacy and safety of coronary artery bypass grafting (CABG) compared to drug-eluting stenting (DES) in patients with diabetes mellitus and multivessel coronary artery disease (CAD). CABG has been the preferred revascularization strategy in patients with diabetes compared to DES. Drug-eluting stents reduce the rate of target vessel revascularization compared to bare-metal stents. The ideal revascularization strategy for patients with diabetes with multivessel CAD in the DES era is unknown. A search of published reports was performed to identify clinical studies comparing CABG with DES in patients with diabetes with multivessel CAD with a minimum follow-up of 1 year. Five studies including 1,543 patients with diabetes (757 who underwent CABG and 786 who underwent DES) met the selection criteria. The mean follow-up period was 18 months (range 12 to 36). Compared to DES, CABG was associated with a lower risk for major adverse cardiac events (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.36 to 0.65), driven mainly by a lower risk for repeat revascularization (OR 0.18, 95% CI 0.11 to 0.30), despite having a higher percentage of triple-vessel disease. There was no significant difference in death (OR 0.85, 95% CI 0.52 to 1.39) or myocardial infarction (OR 0.82, 95% CI 0.41 to 1.61). Patients in the CABG group had a higher risk for cerebrovascular events (OR 2.15, 95% CI 0.99 to 4.68). In conclusion, PCI with DES is safe and may represent a viable alternative to CABG for selected patients with diabetes with multivessel CAD.

Authors+Show Affiliations

Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. mslee@mednet.ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

20494658

Citation

Lee, Michael S., et al. "Meta-analysis of Studies Comparing Coronary Artery Bypass Grafting With Drug-eluting Stenting in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease." The American Journal of Cardiology, vol. 105, no. 11, 2010, pp. 1540-4.
Lee MS, Yang T, Dhoot J, et al. Meta-analysis of studies comparing coronary artery bypass grafting with drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease. Am J Cardiol. 2010;105(11):1540-4.
Lee, M. S., Yang, T., Dhoot, J., Iqbal, Z., & Liao, H. (2010). Meta-analysis of studies comparing coronary artery bypass grafting with drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease. The American Journal of Cardiology, 105(11), 1540-4. https://doi.org/10.1016/j.amjcard.2010.01.009
Lee MS, et al. Meta-analysis of Studies Comparing Coronary Artery Bypass Grafting With Drug-eluting Stenting in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease. Am J Cardiol. 2010 Jun 1;105(11):1540-4. PubMed PMID: 20494658.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis of studies comparing coronary artery bypass grafting with drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease. AU - Lee,Michael S, AU - Yang,Tae, AU - Dhoot,Jashdeep, AU - Iqbal,Zahid, AU - Liao,Hsini, Y1 - 2010/04/08/ PY - 2009/12/01/received PY - 2010/01/11/revised PY - 2010/01/11/accepted PY - 2010/5/25/entrez PY - 2010/5/25/pubmed PY - 2010/7/9/medline SP - 1540 EP - 4 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 105 IS - 11 N2 - This meta-analysis was undertaken to assess the efficacy and safety of coronary artery bypass grafting (CABG) compared to drug-eluting stenting (DES) in patients with diabetes mellitus and multivessel coronary artery disease (CAD). CABG has been the preferred revascularization strategy in patients with diabetes compared to DES. Drug-eluting stents reduce the rate of target vessel revascularization compared to bare-metal stents. The ideal revascularization strategy for patients with diabetes with multivessel CAD in the DES era is unknown. A search of published reports was performed to identify clinical studies comparing CABG with DES in patients with diabetes with multivessel CAD with a minimum follow-up of 1 year. Five studies including 1,543 patients with diabetes (757 who underwent CABG and 786 who underwent DES) met the selection criteria. The mean follow-up period was 18 months (range 12 to 36). Compared to DES, CABG was associated with a lower risk for major adverse cardiac events (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.36 to 0.65), driven mainly by a lower risk for repeat revascularization (OR 0.18, 95% CI 0.11 to 0.30), despite having a higher percentage of triple-vessel disease. There was no significant difference in death (OR 0.85, 95% CI 0.52 to 1.39) or myocardial infarction (OR 0.82, 95% CI 0.41 to 1.61). Patients in the CABG group had a higher risk for cerebrovascular events (OR 2.15, 95% CI 0.99 to 4.68). In conclusion, PCI with DES is safe and may represent a viable alternative to CABG for selected patients with diabetes with multivessel CAD. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/20494658/Meta_analysis_of_studies_comparing_coronary_artery_bypass_grafting_with_drug_eluting_stenting_in_patients_with_diabetes_mellitus_and_multivessel_coronary_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(10)00095-0 DB - PRIME DP - Unbound Medicine ER -