Drug-Eluting Stent Versus Coronary Artery Bypass Grafting for Diabetic Patients With Multivessel and/or Left Main Coronary Artery Disease : A Meta-Analysis

With the development of stent design and surgical techniques, the relative benefit of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and complex coronary artery disease are highly debated. This meta-analysis was conducted to compare the outcomes of drug-eluting stent (DES) implantation and CABG in these cohorts. A comprehensive search of PubMed, Embase, and Cochrane Library up to January 4, 2018, was performed. Only randomized controlled trials (RCTs), subgroup analysis from RCTs, or adjusted observational studies were eligible. Five RCTs and 13 adjusted observational studies involving 17 532 patients were included. Overall, PCI with DES was significantly associated with higher risk of all-cause mortality (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 1.05-1.29), myocardial infarction (MI; HR: 1.69, 95% CI: 1.43-2.00), and repeat revascularization (HR: 3.77, 95% CI: 2.76-5.16) compared with CABG. Nevertheless, the risk of stroke was significantly lower in the DES group (HR: 0.67, 95% CI: 0.54-0.83). The incidence of the composite end point of death, MI, or stroke was comparable between the 2 groups (HR: 0.99, 95% CI: 0.84-1.17). Despite the higher risk of stroke, CABG was better than PCI with DES for diabetic patients with multivessel and/or left main coronary artery disease.

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:70

Enthalten in:

Angiology - 70(2019), 8 vom: 27. Sept., Seite 765-773

Sprache:

Englisch

Beteiligte Personen:

Cui, Kongyong [VerfasserIn]
Lyu, Shuzheng [VerfasserIn]
Song, Xiantao [VerfasserIn]
Liu, Hong [VerfasserIn]
Yuan, Fei [VerfasserIn]
Xu, Feng [VerfasserIn]
Zhang, Min [VerfasserIn]
Wang, Wei [VerfasserIn]
Zhang, Mingduo [VerfasserIn]
Zhang, Dongfeng [VerfasserIn]
Tian, Jinfan [VerfasserIn]

Links:

Volltext

Themen:

Coronary artery bypass grafting
Diabetes
Drug-eluting stent
Journal Article
Left main and/or multivessel disease
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Anmerkungen:

Date Completed 13.08.2019

Date Revised 13.08.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1177/0003319719839885

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM296157058