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PCI vs. CABG in left main with multi-vessel coronary artery disease and diabetes: Case report

Michael Sabina1, Aqeel Khanani1, Amanda Rigdon1

  • 1Lakeland Regional Health Medical Center, Lakeland, FL, USA.

Diabetes & Vascular Disease Research
|May 6, 2024
PubMed

Insights

Percutaneous coronary intervention (PCI) offers a favorable outcome for diabetic patients with left main coronary artery disease (LMCAD) and multivessel disease. This case study suggests PCI may be a superior alternative to coronary artery bypass grafting (CABG) in select high-risk individuals.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine
  • Diabetology

Background:

  • Current guidelines recommend coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) for patients with left main coronary artery disease (LMCAD).
  • Diabetic patients with complex coronary artery disease often face higher risks, traditionally favoring surgical intervention.

Observation:

  • A male patient with diabetes, LMCAD, and extensive multivessel disease presented with a high SYNTAX score (28).
  • Despite the high-risk profile, the patient was successfully treated with PCI.

Findings:

  • Percutaneous coronary intervention (PCI) demonstrated a favorable outcome in this high-risk diabetic patient with left main coronary artery disease (LMCAD).
  • The results challenge the conventional guideline preference for coronary artery bypass grafting (CABG) in similar complex cases.

Implications:

  • PCI may be a viable and potentially superior alternative to CABG for select diabetic patients with left main coronary artery disease (LMCAD) and multivessel disease.
  • This case highlights the need to reconsider treatment strategies for complex coronary artery disease in diabetic populations.

Keywords:
Percutaneous coronary interventioncoronary artery bypass graftingdiabetes mellitusleft main coronary artery diseasemultivessel coronary artery disease

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