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Clinical practice patterns in revascularization of diabetic patients with coronary heart disease: nationwide register

Hanna-Riikka Lehto1, Arto Pietilä1, Teemu J Niiranen1,2

  • 1THL - Finnish Institute for Health and Welfare, Helsinki, Finland.

Annals of Medicine
|May 21, 2020
PubMed

Insights

Diabetic patients with coronary heart disease were more likely to undergo coronary artery bypass grafting (CABG) than percutaneous coronary intervention (PCI), despite PCI being the dominant method overall. Diabetic patients also had more urgent CABG procedures and comorbidities.

Area of Science:

  • Cardiology
  • Diabetology
  • Public Health

Background:

  • Coronary heart disease (CHD) management differs in diabetic patients.
  • Understanding revascularization trends in diabetic versus non-diabetic patients is crucial for optimizing cardiovascular care.

Purpose of the Study:

  • To compare revascularization methods (PCI vs. CABG) in diabetic and non-diabetic patients with CHD.
  • To analyze comorbidities and procedure urgency in these groups.
  • To investigate factors influencing revascularization method choice.

Main Methods:

  • Retrospective analysis of electronic health records from Finland (2000-2015).
  • Inclusion of 33,018 diabetic and 106,224 non-diabetic patients undergoing first-time PCI or CABG.
  • Statistical analysis to compare groups and identify predictors of revascularization method.

Main Results:

  • Percutaneous coronary intervention (PCI) was the most common revascularization method overall.
  • Diabetic patients were more likely to undergo coronary artery bypass grafting (CABG) than PCI (OR 1.30).
  • Diabetic patients had a higher proportion of urgent CABG procedures (26.9% vs. 21.6%) and more comorbidities.

Conclusions:

  • While PCI dominated, CABG was more prevalent in diabetic CHD patients compared to non-diabetic counterparts.
  • Diabetic patients presented with higher urgency and more comorbidities, influencing revascularization choices.
  • Patient characteristics like prior myocardial infarction and comorbidities significantly impacted CABG likelihood in diabetic individuals.

Keywords:
CABGCHDPCIdiabetesrevascularization

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