Long-term clinical outcomes in diabetics after coronary artery bypass surgery and coronary stenting

Sim, Doo Sun; Jeong, Myung Ho; Kim, Weon; Rhew, Jay Young; Yum, Ju Hyup; Kim, Ju Han; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Ahn, Byoung Hee; Kim, Sang Hyung; Kang, Jung Chaee

Abstract

BACKGROUND: Diabetes is a major risk factor for restenosis after percuataneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) has been considered desirable in diabetics with multivessel disease. However, recent developments in devices and techniques of PCI have led to speculation about advantages of CABG in diabetic patients. We sought to compare long-term clinical outcomes of coronary stenting and those of CABG in diabetics with coronary artery disease.
METHODS
Among diabetics who underwent revascularization therapy in Chonnam National University Hospital between Mar 1998 and Feb 1999, 122 patients (Group I, 84 males, 60+/-8 years) who had stent implanted, and 38 patients (Group II, 24 males, 60+/-8 years) who had bypass surgery were selected and their short- and long-term clinical were compared.
RESULTS
As for clinical diagnosis and risk factors there were no differences between the two groups. In ACC/AHA types Group II had more multiple and complex vessel disease than Group I (p<0.05). Incidences of in-hospital adverse cardiac events were not different between the two groups, but during the period of 30.5+/-6.7 months the incidence of target lesion revascularization was significantly higher in Group I (18.9% versus 5.7%, p<0.005).
CONCLUSION
Short-term clinical outcomes of coronary stenting were comparable to those of CABG in patients with diabetes, but the incidence of repeat revascularization was higher in the coronary stenting group. With the advent of adjunctive therapies in the prevention of restenosis after PCI, these results require fu rther clinical assessment.