Comparison of bypass surgery with drug-eluting stents in diabetic patients with left main coronary stenosis.
OBJECTIVE
Several studies have compared the effects of coronary stenting and coronary- artery bypass grafting (CABG) on left main coronary artery (LMCA) disease. However, there are limited data on the long-term outcomes of these two interventions in diabetic patients.


METHODS
We evaluated 56 patients with LMCA stenosis who underwent drug-eluting stent (DES) implantation and 116 patients who underwent CABG in a single hospital in China between January 2004 and December 2006. We compared long-term major adverse cardiac events (death; a "serious outcome" composite of death, myocardial infarction, or stroke; and target-vessel revascularization).


RESULTS
In-hospital (30-day) mortality was 0% for the DES group and 3.4% for the CABG group (p=0.31). There was no difference between the two groups in terms of risk of death [hazard ratio for stenting group, 0.49; 95% confidence interval (CI), 0.13-1.63; p=0.55] or risk of serious outcome (hazard ratio for DES group, 1.11; 95% CI, 0.39-1.45; p=0.47). The target-vessel revascularization rate was higher in the DES group than in the CABG group (hazard ratio, 3.67; 95% CI, 1.24-11.06; p=0.018).


CONCLUSIONS
In this cohort of diabetic patients with LMCA stenosis, there was no difference in composite endpoints between patients receiving DESs and those undergoing CABG. However, stenting was associated with higher rates of target-vessel revascularization than CABG. DES implantation in diabetic patients with LMCA disease was found to be at least as safe as CABG.
Department of Cardiology, Capital University of Medical Sciences, Beijing, China.
Xiaoxiao
X
Zhao
Yujie
Y
Zhou
Hui
H
Song
Like
L
Guan
Guanbin
G
Zheng
Zhehu
Z
Jin
Dongmei
D
Shi
Yuzi
Y
Li
Yonghe
Y
Guo
Guo-Ping
GP
Shi
Xian Wu
XW
Cheng
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D023921:Coronary Stenosis / Q000628:therapy*; D003920:Diabetes Mellitus; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome