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Influence of diabetes mellitus on long-term (five-year) outcomes of drug-eluting stents and coronary artery bypass grafting for multivessel coronary revascularization.
Am J Cardiol. 2012 Jun 01; 109(11):1548-57.AJ

Abstract

Diabetes mellitus is a major risk factor for coronary artery disease (CAD) and for diffuse and progressive atherosclerosis. We evaluated the outcomes of drug-eluting stent (DES) placement and coronary artery bypass grafting (CABG) in 891 diabetic patients (489 for DES implantation and 402 for CABG) and 2,151 nondiabetic patients (1,058 for DES implantation and 1,093 for CABG) with multivessel CAD treated from January 2003 through December 2005 and followed up for a median 5.6 years. Outcomes of interest included death; the composite outcome of death, myocardial infarction (MI), or stroke; and repeat revascularization. In diabetic patients, after adjusting for baseline covariates, 5-year risk of death (hazard ratio 1.01, 95% confidence interval 0.77 to 1.33, p = 0.96) and the composite of death, MI, or stroke (hazard ratio 1.03, 95% confidence interval 0.80 to 1.31, p = 0.91) were similar in patients undergoing DES or CABG. However, rate of repeat revascularization was significantly higher in the DES group (hazard ratio 3.69, 95% confidence interval 2.64 to 5.17, p <0.001). These trends were consistent in nondiabetic patients (hazard ratio 0.80, 95% confidence interval 0.55 to 1.16, p = 0.23 for death; hazard ratio 0.77, 95% confidence interval 0.56 to 1.05, p = 0.10 for composite of death, MI, or stroke; hazard ratio 2.77, 95% CI 1.95 to 3.91, p <0.001 for repeat revascularization). There was no significant interaction between diabetic status and treatment strategy on clinical outcomes (p for interaction = 0.36 for death; 0.20 for the composite of death, MI, or stroke; and 0.40 for repeat revascularization). In conclusion, there was no significant prognostic influence of diabetes on long-term treatment with DES or CABG in patients with multivessel CAD.

Authors+Show Affiliations

Division of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22425329

Citation

Kim, Yong-Giun, et al. "Influence of Diabetes Mellitus On Long-term (five-year) Outcomes of Drug-eluting Stents and Coronary Artery Bypass Grafting for Multivessel Coronary Revascularization." The American Journal of Cardiology, vol. 109, no. 11, 2012, pp. 1548-57.
Kim YG, Park DW, Lee WS, et al. Influence of diabetes mellitus on long-term (five-year) outcomes of drug-eluting stents and coronary artery bypass grafting for multivessel coronary revascularization. Am J Cardiol. 2012;109(11):1548-57.
Kim, Y. G., Park, D. W., Lee, W. S., Park, G. M., Sun, B. J., Lee, C. H., Hwang, K. W., Cho, S. W., Kim, Y. R., Song, H. G., Ahn, J. M., Kim, W. J., Lee, J. Y., Kang, S. J., Lee, S. W., Kim, Y. H., Lee, C. W., Park, S. W., Han, S., ... Park, S. J. (2012). Influence of diabetes mellitus on long-term (five-year) outcomes of drug-eluting stents and coronary artery bypass grafting for multivessel coronary revascularization. The American Journal of Cardiology, 109(11), 1548-57. https://doi.org/10.1016/j.amjcard.2012.01.377
Kim YG, et al. Influence of Diabetes Mellitus On Long-term (five-year) Outcomes of Drug-eluting Stents and Coronary Artery Bypass Grafting for Multivessel Coronary Revascularization. Am J Cardiol. 2012 Jun 1;109(11):1548-57. PubMed PMID: 22425329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of diabetes mellitus on long-term (five-year) outcomes of drug-eluting stents and coronary artery bypass grafting for multivessel coronary revascularization. AU - Kim,Yong-Giun, AU - Park,Duk-Woo, AU - Lee,Woo Seok, AU - Park,Gyung-Min, AU - Sun,Byung Joo, AU - Lee,Chang Hoon, AU - Hwang,Ki Won, AU - Cho,Sung Won, AU - Kim,Yoo Ri, AU - Song,Hae Geun, AU - Ahn,Jung-Min, AU - Kim,Won-Jang, AU - Lee,Jong-Young, AU - Kang,Soo-Jin, AU - Lee,Seung-Whan, AU - Kim,Young-Hak, AU - Lee,Cheol Whan, AU - Park,Seong-Wook, AU - Han,Seungbong, AU - Jung,Sung-Ho, AU - Choo,Suk Jung, AU - Chung,Cheol Hyun, AU - Lee,Jae-Won, AU - Park,Seung-Jung, Y1 - 2012/03/16/ PY - 2011/11/02/received PY - 2012/01/12/revised PY - 2012/01/12/accepted PY - 2012/3/20/entrez PY - 2012/3/20/pubmed PY - 2012/7/20/medline SP - 1548 EP - 57 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 109 IS - 11 N2 - Diabetes mellitus is a major risk factor for coronary artery disease (CAD) and for diffuse and progressive atherosclerosis. We evaluated the outcomes of drug-eluting stent (DES) placement and coronary artery bypass grafting (CABG) in 891 diabetic patients (489 for DES implantation and 402 for CABG) and 2,151 nondiabetic patients (1,058 for DES implantation and 1,093 for CABG) with multivessel CAD treated from January 2003 through December 2005 and followed up for a median 5.6 years. Outcomes of interest included death; the composite outcome of death, myocardial infarction (MI), or stroke; and repeat revascularization. In diabetic patients, after adjusting for baseline covariates, 5-year risk of death (hazard ratio 1.01, 95% confidence interval 0.77 to 1.33, p = 0.96) and the composite of death, MI, or stroke (hazard ratio 1.03, 95% confidence interval 0.80 to 1.31, p = 0.91) were similar in patients undergoing DES or CABG. However, rate of repeat revascularization was significantly higher in the DES group (hazard ratio 3.69, 95% confidence interval 2.64 to 5.17, p <0.001). These trends were consistent in nondiabetic patients (hazard ratio 0.80, 95% confidence interval 0.55 to 1.16, p = 0.23 for death; hazard ratio 0.77, 95% confidence interval 0.56 to 1.05, p = 0.10 for composite of death, MI, or stroke; hazard ratio 2.77, 95% CI 1.95 to 3.91, p <0.001 for repeat revascularization). There was no significant interaction between diabetic status and treatment strategy on clinical outcomes (p for interaction = 0.36 for death; 0.20 for the composite of death, MI, or stroke; and 0.40 for repeat revascularization). In conclusion, there was no significant prognostic influence of diabetes on long-term treatment with DES or CABG in patients with multivessel CAD. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/22425329/Influence_of_diabetes_mellitus_on_long_term__five_year__outcomes_of_drug_eluting_stents_and_coronary_artery_bypass_grafting_for_multivessel_coronary_revascularization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(12)00593-0 DB - PRIME DP - Unbound Medicine ER -