title: Coronary artery bypass graft versus percutaneous coronary intervention with drug-eluting stent implantation for diabetic patients with unprotected left main coronary artery disease: the D-DELTA registry.
abstract: OBJECTIVE
  Data regarding the impact on clinical outcomes of PCI with DES implantation vs. CABG to treat unprotected left main coronary artery (ULMCA) disease in diabetic patients are still insufficient. The present study evaluated the short-term and long-term results of percutaneous and surgical revascularisation in diabetic patients with ULMCA disease in a large population.
  
  
  RESULTS
  A total of 826 diabetic patients with ULMCA stenosis who received DES (n=520) or underwent CABG (n=306) were selected and analysed from the DELTA registry. In-hospital MACCE was significantly higher in the CABG group, mainly driven by a higher incidence of MI. At four-year follow-up, freedom from death and the composite endpoint of death, MI and cerebrovascular accident (CVA) was similar in the two treatment groups (CABG 87.4%, PCI 82.5%, p=0.124, and CABG 85.4%, PCI 78.9%, p=0.11, respectively). Conversely, freedom from TVR and MACCE was significantly higher in the CABG compared to the PCI group (CABG 95.4%, PCI 79.4%, p<0.001, and CABG 81.9%, PCI 64.7%, p<0.001).
  
  
  CONCLUSIONS
  In diabetic patients with ULMCA disease with/without concomitant multivessel disease, PCI and CABG led to similar results in terms of death, MI and CVA. However, CABG was associated with less MACCE at long-term follow-up, primarily due to the higher repeat revascularisation rate with DES.
authors.affiliation: Interventional Cardiology Unit, A.O. Ordine Mauriziano Umberto I, Turin, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.forename: Mauro
authors.initials: M
authors.lastname: De Benedictis
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Piera
authors.initials: P
authors.lastname: Capranzano
authors.forename: Sanda
authors.initials: S
authors.lastname: Jegere
authors.forename: Raj
authors.initials: R
authors.lastname: Makkar
authors.forename: Igor
authors.initials: I
authors.lastname: Palacios
authors.forename: Pawel
authors.initials: P
authors.lastname: Buszman
authors.forename: Marta
authors.initials: M
authors.lastname: Bande
authors.forename: Tarun
authors.initials: T
authors.lastname: Chakravarty
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Christoph
authors.initials: C
authors.lastname: Naber
authors.forename: Innocenzo
authors.initials: I
authors.lastname: Scrocca
authors.forename: Ronan
authors.initials: R
authors.lastname: Margey
authors.forename: Martin
authors.initials: M
authors.lastname: Leon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Moses
authors.forename: Jean
authors.initials: J
authors.lastname: Fajadet
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.forename: Marie Claude
authors.initials: MC
authors.lastname: Morice
authors.forename: Andrejs
authors.initials: A
authors.lastname: Erglis
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Ottavio
authors.initials: O
authors.lastname: Alfieri
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Conte
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000628:therapy; D003920:Diabetes Mellitus; D054855:Drug-Eluting Stents; D006801:Humans; D062645:Percutaneous Coronary Intervention; D012042:Registries; D016896:Treatment Outcome