Why the study?
The study was conducted to explore the outcomes of percutaneous coronary intervention in diabetic versus non-diabetic patients with prior coronary artery bypass grafting surgery.
Does diabetes mellitus worsen clinical outcomes in patients with prior CABG undergoing PCI with drug-eluting stents?
Does diabetes mellitus worsen clinical outcomes in patients with prior CABG undergoing PCI with drug-eluting stents?
In patients with prior CABG undergoing PCI with drug-eluting stents, the presence of diabetes mellitus did not significantly increase the risk of major adverse cardiac events over a median follow-up of 5.13 years.
Diabetes may not increase MACE risk after DES-PCI in prior CABG; leaves open confirmation in larger prospective studies.
Background: The target of this study was to explore the outcomes of percutaneous coronary intervention (PCI) in diabetic versus non-diabetic patients with prior coronary artery bypass grafting (CABG) surgery. Methods: Seven hundred and twenty four patients who had previously received CABG and had been treated using PCI combined with drug-eluting stents (DES) between 2009 and 2017 were selected for a retrospective study and allocated into either a diabetes mellitus (DM) or non-diabetes mellitus (No DM) group. A 1:1 propensity score-matched evaluation was conducted and risk adjusted for analysis. The primary outcomes were cardiac death, myocardial infarction, heart failure and revascularization, with a median follow-up duration of 5.13 years. Results: After matching, two-, 5- and 8-year event rate of overall major adverse cardiac events (MACEs) were found to be higher in the DM group (No DM vs DM:15.3%, 30.9%, 38.5% vs 19.8%, 37.8%, 52.2%, respectively), although no significant difference was found in the event rate of overall MACEs (hazard ratio [HR]: 1.35; 95% confidence interval [CI]: 1.00 to 1.83 for DM vs No DM; P=0.052), cardiac death (HR: 0.94; 95% CI: 0.45 to 1.95; P=0.871), MI (HR: 1.49; 95% CI: 0.95 to 2.32; P=0.080), HF (HR: 1.54; 95% CI: 0.90 to 2.63 for; P=0.120) or revascularization (HR: 1.07; 95% CI: 0.72 to 1.59; P=0.747). Subgroup analysis of PCI in only the NCA showed MACEs (adjusted HR: 1.13; 95% CI: 0.85 to 1.49 for DM vs No DM; P=0.325), cardiac death (adjusted HR: 0.85; 95% CI: 0.41 to 1.78 for DM vs No DM; P=0.781), MI (adjusted HR: 1.32; 95% CI: 0.84 to 2.01 for DM vs No DM; P=0.069), HF (adjusted HR: 1.41; 95% CI: 0.87 to 2.27 for DM vs No DM; P=0.211) or repeated revascularization (adjusted HR: 0.93; 95% CI: 0.64 to 1.37 for DM vs No DM; P=0.836). Conclusions : Compared with non-diabetic patients with prior CABG, subsequent implantation of DES in the native coronary artery of diabetic patients resulted in apparently similar outcomes. Trial registration : This study was not registered in an open access database.
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Ma et al. (2019) studied this question.
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