title: Twelve months clinical outcome of drug-eluting stents implantation or coronary artery bypass surgery for the treatment of diabetic patients with multivessel disease.
abstract: BACKGROUND
  Studies comparing coronary artery bypass grafting (CABG) with drug-eluting stent (DES) for the treatment of diabetic patients with multivessel disease are relatively scarce although controversies exist concerning the relative efficacy of CABG versus DES.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the effect of drug-eluting stent (DES) implantation in diabetic patients with multivessel disease compared with CABG.
  
  
  METHODS
  We included 645 consecutive diabetic patients who underwent either CABG (n = 282) or DES implantation (n = 363) in our institution from July 2003 to December 2005.
  
  
  RESULTS
  At 12 mo after index revascularization procedure, the total mortality rate was similar in the CABG and DES group (3.2% versus 3.0%, hazard ratio [HR] of CABG versus percutaneous coronary intervention [PCI] 0.58, 95% confidence interval [CI]: 0.14 to 2.45, p = 0.460), but the rate of major adverse cardiac cerebrovascular events was lower in the CABG group (7.8% versus 17.9%, HR: 0.15, 95% CI: 0.06 to 0.37, p < 0.001) mainly due to less repeat revascularization with CABG (1.4% versus 11.6%, HR: 0.02, 95% CI: 0.01 to 0.13, p < 0.001). Age, 3-vessel disease, and serum creatinine > or =1.5 mg/dl were positive independent predictors of 12 mo death.
  
  
  CONCLUSIONS
  At 12 mo, CABG was associated with less adverse events primarily due to less repeat revascularization compared with DES although there was no significant difference in mortality and myocardial infarction (MI) rates between the 2 groups; high repeat revascularization rate related to DES resulted from high restenosis rate in diabetic patients and lower rate of complete revascularization offered by PCI.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Qiao
authors.forename: Changsheng
authors.initials: C
authors.lastname: Ma
authors.forename: Shaoping
authors.initials: S
authors.lastname: Nie
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Liu
authors.forename: Junping
authors.initials: J
authors.lastname: Kang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lv
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.forename: Rong
authors.initials: R
authors.lastname: Hu
authors.forename: Yin
authors.initials: Y
authors.lastname: Zhang
authors.forename: Changqi
authors.initials: C
authors.lastname: Jia
authors.forename: Xinmin
authors.initials: X
authors.lastname: Liu
authors.forename: Jianzeng
authors.initials: J
authors.lastname: Dong
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.forename: Yujie
authors.initials: Y
authors.lastname: Zhou
authors.forename: Shuzheng
authors.initials: S
authors.lastname: Lv
authors.forename: Fangjiong
authors.initials: F
authors.lastname: Huang
authors.forename: Chengxiong
authors.initials: C
authors.lastname: Gu
authors.forename: Xuesi
authors.initials: X
authors.lastname: Wu
mesh_terms: D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000209:etiology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D003404:Creatinine / Q000097:blood; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine