title: Unprotected left main coronary artery disease after revascularization : effect of diabetes on patient outcomes.
abstract: OBJECTIVE
  It is unknown whether the effect of diabetes on patients with unprotected left main coronary artery (LMCA) disease differs according to the different revascularization strategies. This study was conducted to evaluate the impact of diabetes on patients with unprotected LMCA disease treated with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
  
  
  METHODS
  We prospectively enrolled 823 consecutive patients with unprotected LMCA disease who had drug-eluting stent (DES; n = 331) implantation or underwent CABG (n = 492) in the study. We compared the effects of diabetes on clinical outcomes according to different revascularization strategies.
  
  
  RESULTS
  Among 823 eligible patients enrolled, 226 had diabetes. In the DES population, no significant differences were observed in occurrences of death, cardiac death, repeat revascularization, stroke, and major adverse cardiac and cerebrovascular events. However, the risks of the composite of death/myocardial infarction (MI)/stroke (21.5 % DM vs. 7.2 % non-DM; p = 0.001) and MI (15.4 % DM vs. 1.6 % non-DM; p = 0.000) were significantly higher in the diabetic patients than those without diabetes. In the CABG population, similar rates of all clinical endpoints were observed between the diabetic and nondiabetic group.
  
  
  CONCLUSIONS
  Diabetes was associated with worse outcome in patients undergoing DES implantation for the treatment of unprotected LMCA disease. However, its negative prognostic impact was not found among patients undergoing CABG.
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Disease, 2 Anzhen Road, 100029, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Yu
authors.forename: Y
authors.initials: Y
authors.lastname: Luo
authors.forename: J
authors.initials: J
authors.lastname: He
authors.forename: Y
authors.initials: Y
authors.lastname: Gao
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: C
authors.initials: C
authors.lastname: Wu
authors.forename: X
authors.initials: X
authors.lastname: Ren
authors.forename: S
authors.initials: S
authors.lastname: Lv
authors.forename: F
authors.initials: F
authors.lastname: Chen
mesh_terms: D002681:China / Q000453:epidemiology; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery*; D048909:Diabetes Complications / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*; D015996:Survival Rate; D016896:Treatment Outcome