title: [Meta-analysis of coronary artery bypass surgery compared to percutaneous transluminal angioplasty with stent in diabetic patients].
abstract: BACKGROUND
  Diabetic patients are a group of primary interest in the study of myocardial revascularization.
  
  
  OBJECTIVE
  To compare coronary artery bypass grafting surgery (CABG) and percutaneous angioplasty with stents (PCI-S) in diabetic patients with coronary three-vessel or left main coronary artery disease.
  
  
  METHODS
  Meta-analysis of MEDLINE randomized controlled studies comparing CABG and PCI-S in diabetic patients. The primary outcome measure was major adverse cardiovascular events (MACCE), death, myocardial infarction, cerebrovascular accident (CVA) and coronary re-intervention. Secondary outcomes were the individual components of MACCE.
  
  
  RESULTS
  Three studies comparing CABG and PCI-S met the inclusion criteria. One thousand sixty two patients were studied: 565 in the CABG group and 597 in the PCI-S group. At one year follow up MACCE occurred in 24.9 and 12.7% of patients in PCI-S and CABG groups, respectively (Odds ratio (OR) 2.27; 95% confidence intervals (CI) 1.66-3.09). There were no differences in death or myocardial infarction. Strokes were less common in the PCI-S group (OR 0.25, 95% CI0.09-0.68) and coronary re-intervention was required with higher frequency in the PCI-S group (OR 5.32, 95% CI 3.27-8.67).
  
  
  CONCLUSIONS
  In diabetic patients with three-vessel coronary disease or left main coronary artery, revascularization with CABG had significantly less MACCE at one year than those treated with PCI-S. Stroke frequency was higher in CABG, coronary re-intervention was higher in PCI-S. These results must be interpreted cautiously.
authors.affiliation: División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ajjadue@uc.cl
authors.forename: Andrés
authors.initials: A
authors.lastname: Jadue T
authors.forename: Roberto
authors.initials: R
authors.lastname: González L
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Irarrázabal L L
mesh_terms: D017130:Angioplasty; D018849:Controlled Clinical Trials as Topic; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000628:therapy*; D058065:Diabetic Cardiomyopathies / Q000628:therapy*; D006801:Humans; D016017:Odds Ratio; D015607:Stents