Reassessing Revascularization Strategies in Coronary Artery Disease and Type 2 Diabetes Mellitus

Frontiers in Cardiovascular Medicine

Ning Gu¹  Bo Liang²  Xin He² 

[1] Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China;Nanjing University of Chinese Medicine, Nanjing, China;

关键词: coronary artery disease;    type 2 diabetes mellitus;    coronary artery bypass surgery;    percutaneous coronary intervention;    adverse clinical outcomes;   

DOI  :  10.3389/fcvm.2021.738620

来源: DOAJ

【 摘 要 】

Percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is still controversial in patients with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM). Here, we aimed to evaluate the long-term follow-up events of PCI and CABG in these populations. Relevant randomized controlled trials were retrieved from PubMed, Embase, and the Cochrane databases. The pooled results were represented as risk ratios (RRs) with 95% confidence intervals (CIs) with STATA software. A total of six trials with 1,766 patients who received CABG and 2,262 patients who received PCI were included in our study. Patients in the CABG group were significantly associated with a lower all-cause mortality compared with those in the PCI group (RR = 0.74, 95% CI = 0.56–0.98, P = 0.037). Cardiac mortality, recurrent myocardial infarction, and repeat revascularization were also significantly lower in the CABG group (RR = 0.79, 95% CI = 0.40–1.53, P = 0.479; RR = 0.70, 95% CI = 0.32–1.56, P = 0.387; and RR = 0.36, 95% CI = 0.28–0.46, P < 0.0001; respectively). However, compared with the PCI group, the cerebral vascular accident was higher in the CABG group (RR = 2.18, 95% CI = 1.43–3.33, P < 0.0001). There was no publication bias in our study. CABG revascularization was associated with significantly lower long-term adverse clinical outcomes, except cerebral vascular accident, compared with PCI in patients with CAD and T2DM.Systematic Review Registration: PROSPERO, identifier: CRD42020216014.

【 授权许可】

Unknown