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Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis

PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluat...

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Autores principales: Zhao, Xiaoxiao, Zhou, Yujie, Song, Hui, Guan, Like, Zheng, Guanbin, Jin, Zhehu, Shi, Dongmei, Li, Yuzi, Guo, Yonghe, Shi, Guo-Ping, Cheng, Xian Wu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220255/
https://www.ncbi.nlm.nih.gov/pubmed/22028155
http://dx.doi.org/10.3349/ymj.2011.52.6.923
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author Zhao, Xiaoxiao
Zhou, Yujie
Song, Hui
Guan, Like
Zheng, Guanbin
Jin, Zhehu
Shi, Dongmei
Li, Yuzi
Guo, Yonghe
Shi, Guo-Ping
Cheng, Xian Wu
author_facet Zhao, Xiaoxiao
Zhou, Yujie
Song, Hui
Guan, Like
Zheng, Guanbin
Jin, Zhehu
Shi, Dongmei
Li, Yuzi
Guo, Yonghe
Shi, Guo-Ping
Cheng, Xian Wu
author_sort Zhao, Xiaoxiao
collection PubMed
description PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization). RESULTS: In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018). CONCLUSION: In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG.
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spelling pubmed-32202552011-11-21 Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis Zhao, Xiaoxiao Zhou, Yujie Song, Hui Guan, Like Zheng, Guanbin Jin, Zhehu Shi, Dongmei Li, Yuzi Guo, Yonghe Shi, Guo-Ping Cheng, Xian Wu Yonsei Med J Original Article PURPOSE: Several studies have compared the effects of coronary stenting and coronary-artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients. MATERIALS AND METHODS: We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization). RESULTS: In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018). CONCLUSION: In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG. Yonsei University College of Medicine 2011-11-01 2011-10-20 /pmc/articles/PMC3220255/ /pubmed/22028155 http://dx.doi.org/10.3349/ymj.2011.52.6.923 Text en © Copyright: Yonsei University College of Medicine 2011 http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Zhao, Xiaoxiao
Zhou, Yujie
Song, Hui
Guan, Like
Zheng, Guanbin
Jin, Zhehu
Shi, Dongmei
Li, Yuzi
Guo, Yonghe
Shi, Guo-Ping
Cheng, Xian Wu
Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis
title Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis
title_full Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis
title_fullStr Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis
title_full_unstemmed Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis
title_short Comparison of Bypass Surgery with Drug-Eluting Stents in Diabetic Patients with Left Main Coronary Stenosis
title_sort comparison of bypass surgery with drug-eluting stents in diabetic patients with left main coronary stenosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220255/
https://www.ncbi.nlm.nih.gov/pubmed/22028155
http://dx.doi.org/10.3349/ymj.2011.52.6.923
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