A 3-year clinical outcome after percutaneous coronary intervention using sirolimus-eluting stent and off-pump coronary artery bypass grafting for the treatment of diabetic patients with multivessel disease.
BACKGROUND
There are few data to compare the long-term efficacy of sirolimus-eluting stent (SES) and off-pump coronary artery bypass grafting (OPCAB) for diabetic patients with multivessel disease (MVD).


RESULTS
In a single-center non-randomized registry, 208 diabetic patients with MVD were examined (SES group: n=92, OPCAB group: n=116). The occurrence of major adverse cardiac and cerebrovascular events (MACCE, defined as all-cause death, non-fatal myocardial infarction, cerebrovascular event, and repeat revascularization) was compared between the 2 groups. Fasting blood glucose level, type of diabetic treatment and the prevalence of diabetic major vascular complications were similar between groups. The SES group had a significantly higher prevalence of 2-vessel disease and a significantly lower prevalence of 3-vessel disease compared with the OPCAB group. During the follow-up period (mean: 42+/-8 months), the rate of revascularization was significantly higher in the SES group than the OPCAB group (21% vs 6.9%, P=0.003). On the other hand, there was a significant higher occurrence of cerebrovascular events in the OPCAB group. Finally, the cumulative MACCE was similar between the 2 groups (27% vs 23%, P=0.492).


CONCLUSIONS
At the 3-year clinical follow-up, the prevalence of MACCE in diabetic patients with MVD was comparable between the SES and the OPCAB groups.
Department of Cardiology, National Cardiovascular Center, Suita, Japan.
Ken-ichirou
K
Yamagata
Yu
Y
Kataoka
Nobuaki
N
Kokubu
Yoichiro
Y
Kasahara
Mitsuru
M
Abe
Hiroyuki
H
Nakajima
Junjiro
J
Kobayashi
Yoritaka
Y
Otsuka
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001786:Blood Glucose; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology / Q000628:therapy*; D048909:Diabetes Complications / Q000150:complications; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome
D001786:Blood Glucose; D020123:Sirolimus