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Percutaneous coronary intervention in diabetic versus non-diabetic patients with prior coronary artery bypass

Xiaolong Ma1, Ran Dong1, Pengfei Chen1

  • 1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

BMC Cardiovascular Disorders
|April 8, 2020
PubMed

Insights

Diabetic patients with prior coronary artery bypass grafting (CABG) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) showed similar outcomes to non-diabetic patients. This finding suggests comparable safety and efficacy for PCI in diabetic individuals post-CABG.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetes Mellitus Research

Background:

  • Prior coronary artery bypass grafting (CABG) surgery is a significant factor in managing coronary artery disease.
  • Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is an alternative revascularization strategy.
  • Understanding outcomes in diabetic versus non-diabetic patients post-CABG undergoing PCI is crucial for clinical decision-making.

Purpose of the Study:

  • To compare the long-term clinical outcomes of PCI using DES in diabetic versus non-diabetic patients who have previously undergone CABG.
  • To evaluate the safety and efficacy of PCI in this specific patient population.

Main Methods:

  • A retrospective study included 724 patients who received PCI with DES after CABG between 2009 and 2017.
  • Patients were divided into diabetes mellitus (DM) and non-diabetes mellitus (No DM) groups.
  • A 1:1 propensity score-matched analysis was performed, adjusting for relevant risk factors, with a median follow-up of 5.13 years.

Main Results:

  • While the event rates for major adverse cardiac events (MACEs) were numerically higher in the DM group at 2, 5, and 8 years, no statistically significant difference was observed in overall MACEs (HR: 1.35; P=0.052) or its components including cardiac death, myocardial infarction (MI), heart failure (HF), or revascularization.
  • Subgroup analysis focusing on PCI in the native coronary artery (NCA) also revealed no significant differences in MACEs, cardiac death, MI, HF, or revascularization between the DM and No DM groups.

Conclusions:

  • Subsequent implantation of DES in the native coronary artery of diabetic patients following CABG resulted in outcomes comparable to those in non-diabetic patients.
  • These findings suggest that PCI with DES is a viable and safe treatment option for diabetic patients with prior CABG.
Abstract

Keywords:
DiabeticNon-diabeticOutcomesPercutaneous coronary interventionPrior coronary artery bypass grafting

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