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Author Spotlight: Enhancing Coronary Artery Revascularization
05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

937

Outcomes after coronary artery bypass grafting and percutaneous coronary intervention in diabetic and non-diabetic

Hanna-Riikka Lehto1,2, Klas Winell2, Arto Pietilä2

  • 1Department of Public Health, University of Turku, 20014 Turku, Finland.

European Heart Journal. Quality of Care & Clinical Outcomes
|September 8, 2021
PubMed

Insights

Percutaneous coronary intervention (PCI) offers better short-term outcomes for coronary heart disease (CHD) patients. However, coronary artery bypass grafting (CABG) shows superior long-term prognosis, particularly for diabetic individuals undergoing myocardial revascularisation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Public Health

Background:

  • Coronary heart disease (CHD) management involves revascularisation procedures like percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).
  • Real-world practice data is crucial for understanding the long-term prognosis associated with these interventions, especially in diverse patient populations.

Purpose of the Study:

  • To evaluate the prognosis of patients with CHD following their first myocardial revascularisation.
  • To compare the outcomes of PCI versus CABG in both diabetic and non-diabetic patients.

Main Methods:

  • Utilized Finland's national hospital discharge register for data on cardiac revascularisations from 2000-2015.
  • Tracked outcomes including all-cause and cardiovascular deaths, major adverse events, and repeat revascularisation at 28 days, 1 year, and 3 years.

Main Results:

  • Over 139,000 revascularisations were analyzed; 24% of patients had diabetes.
  • Non-diabetic patients had lower 28-day mortality with PCI versus CABG; no difference was observed in diabetic patients.
  • Long-term follow-up revealed PCI was associated with higher risks of death and adverse events compared to CABG, especially in diabetic patients at 3 years.

Conclusions:

  • PCI demonstrates a better short-term prognosis (28 days) post-revascularisation.
  • CABG appears to offer a superior long-term prognosis, particularly for diabetic patients, highlighting the need for personalized treatment strategies.
Abstract

Keywords:
Coronary artery bypass surgeryCoronary heart diseaseDiabetesPercutaneous coronary interventionPrognosisSurvival

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