Related Experiment Video

Updated: May 16, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

Five-year outcomes of surgical or percutaneous myocardial revascularization in diabetic patients

Giovanni Andrea Contini1, Francesco Nicolini, Daniela Fortuna

  • 1Unità Operativa di Cardiochirurgia, Dipartimento Cardio-nefro-polmonare, Azienda Ospedaliero-Universitaria di Parma, Italy.

International Journal of Cardiology
|November 21, 2012
PubMed

Insights

Coronary artery bypass grafting (CABG) showed better outcomes than percutaneous coronary intervention (PCI) in diabetic patients with multivessel coronary disease. CABG resulted in lower rates of major adverse cardiac and cerebrovascular events (MACCE) over five years.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Diabetic patients with multivessel coronary disease face unclear optimal revascularization strategies.
  • Comparison of five-year clinical outcomes between Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) is crucial.

Purpose of the Study:

  • To compare the five-year clinical outcomes of CABG versus PCI in a real-world population of diabetic patients with multivessel coronary disease.
  • To evaluate whether surgical or percutaneous revascularization is preferred in this patient group.

Main Methods:

  • A cohort of 2885 diabetic patients with multivessel coronary disease undergoing CABG (1466) or PCI (1419) between 2002-2008 was analyzed.
  • Five-year incidences of Major Adverse Cardiac and Cerebrovascular Events (MACCE), including mortality, Acute Myocardial Infarction (AMI), stroke, and repeat revascularization (TVR), were assessed.
  • Analyses included Kaplan-Meier estimates, Cox regression, and competing risk evaluation, also in propensity score-matched subgroups.

Main Results:

  • Percutaneous Coronary Intervention (PCI) was associated with significantly higher all-cause mortality (HR: 1.8), AMI (HR: 3.3), and TVR (HR: 4.5) compared to CABG.
  • No significant difference was observed in stroke rates between PCI and CABG.
  • The increased incidence of AMI in the PCI group contributed to higher overall mortality.

Conclusions:

  • Diabetic patients with multivessel coronary disease experience a higher incidence of MACCE with PCI compared to CABG.
  • Diabetes status and its control are important factors to consider when selecting the revascularization strategy.
Abstract

Keywords:
ASSRBMSCABGCADCHFCIFCOPDCoronary diseaseDESDiabetes mellitusEFHRKMKaplan–Meier estimateLMCAMACCEMACEN-STEMIPCI-SPSPVDREALRERICRegional Agency for Health and Social CareRegional Registry of Cardiac SurgeryRegional Registry of Coronary AngioplastiesRevascularizationSDST-elevation myocardial infarctionSTEMIStentsSurgerybare metal stentschronic obstructive pulmonary diseasecongestive heart failurecoronary artery bypass graftingcoronary artery diseasecumulative incidence functiondrug eluting stentsejection fractionhazard ratioleft main coronary arterymajor adverse cardiac eventsmajor adverse cardiovascular and cerebrovascular events [death, acute myocardial infarction [AMI], treated vessel revascularization [TVR] and stroke]non ST elevation myocardial infarctionpercutaneous coronary angioplasty with stentingperipheral vascular diseasepropensity scorestandard deviation

More Related Videos

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...