TY - JOUR
T1 - Coronary artery bypass graft versus percutaneous coronary intervention with drug-eluting stent implantation for diabetic patients with unprotected left main coronary artery disease
T2 - The D-DELTA registry
AU - Meliga, Emanuele
AU - De Benedictis, Mauro
AU - Chieffo, Alaide
AU - Latib, Azeem
AU - Park, Seung Jung
AU - Kim, Young Hak
AU - Onuma, Yoshinobu
AU - Capranzano, Piera
AU - Jegere, Sanda
AU - Makkar, Raj
AU - Palacios, Igor
AU - Buszman, Pawel
AU - Bande, Marta
AU - Chakravarty, Tarun
AU - Mehran, Roxana
AU - Naber, Christoph
AU - Scrocca, Innocenzo
AU - Margey, Ronan
AU - Leon, Martin
AU - Moses, Jeffrey
AU - Fajadet, Jean
AU - Lefèvre, Thierry
AU - Morice, Marie Claude
AU - Erglis, Andrejs
AU - Tamburino, Corrado
AU - Alfieri, Ottavio
AU - Conte, Maria Rosa
AU - Serruys, Patrick W.
AU - Colombo, Antonio
PY - 2013/11
Y1 - 2013/11
N2 - Aims: Data regarding the impact on clinical outcomes of PCI with DES implantation vs. CABG to treat unprotected left main coronary artery (ULMCA) disease in diabetic patients are still insufficient. The present study evaluated the short-term and long-term results of percutaneous and surgical revascularisation in diabetic patients with ULMCA disease in a large population. Methods and results: A total of 826 diabetic patients with ULMCA stenosis who received DES (n=520) or underwent CABG (n=306) were selected and analysed from the DELTA registry. In-hospital MACCE was significantly higher in the CABG group, mainly driven by a higher incidence of MI. At four-year follow-up, freedom from death and the composite endpoint of death, MI and cerebrovascular accident (CVA) was similar in the two treatment groups (CABG 87.4%, PCI 82.5%, p=0.124, and CABG 85.4%, PCI 78.9%, p=0.11, respectively). Conversely, freedom from TVR and MACCE was significantly higher in the CABG compared to the PCI group (CABG 95.4%, PCI 79.4%, p<0.001, and CABG 81.9%, PCI 64.7%, p<0.001). Conclusions: In diabetic patients with ULMCA disease with/without concomitant multivessel disease, PCI and CABG led to similar results in terms of death, MI and CVA. However, CABG was associated with less MACCE at long-term follow-up, primarily due to the higher repeat revascularisation rate with DES.
AB - Aims: Data regarding the impact on clinical outcomes of PCI with DES implantation vs. CABG to treat unprotected left main coronary artery (ULMCA) disease in diabetic patients are still insufficient. The present study evaluated the short-term and long-term results of percutaneous and surgical revascularisation in diabetic patients with ULMCA disease in a large population. Methods and results: A total of 826 diabetic patients with ULMCA stenosis who received DES (n=520) or underwent CABG (n=306) were selected and analysed from the DELTA registry. In-hospital MACCE was significantly higher in the CABG group, mainly driven by a higher incidence of MI. At four-year follow-up, freedom from death and the composite endpoint of death, MI and cerebrovascular accident (CVA) was similar in the two treatment groups (CABG 87.4%, PCI 82.5%, p=0.124, and CABG 85.4%, PCI 78.9%, p=0.11, respectively). Conversely, freedom from TVR and MACCE was significantly higher in the CABG compared to the PCI group (CABG 95.4%, PCI 79.4%, p<0.001, and CABG 81.9%, PCI 64.7%, p<0.001). Conclusions: In diabetic patients with ULMCA disease with/without concomitant multivessel disease, PCI and CABG led to similar results in terms of death, MI and CVA. However, CABG was associated with less MACCE at long-term follow-up, primarily due to the higher repeat revascularisation rate with DES.
KW - Coronary artery bypass graft
KW - Diabetes
KW - Drug-eluting stents
KW - Unprotected left main coronary artery disease
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U2 - 10.4244/EIJV9I7A133
DO - 10.4244/EIJV9I7A133
M3 - Article
C2 - 24280156
AN - SCOPUS:84890469558
SN - 1774-024X
VL - 9
SP - 803
EP - 808
JO - EuroIntervention
JF - EuroIntervention
IS - 7
ER -