Short-term and long-term outcomes of different revasularizaton strategies in coronary heart disease patients with diabetes mellitus / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate and compare the short-term and long-term outcomes between percutaneous coronary intervention(PCI) or coronary artery bypass graft(CABG) in coronary heart disease(CHD) patients comorbid with diabetes mellitus.Methods The DESIRE register study(Drug-Cluting Stent Impact on REvascularization) was a single-center retrospective study which enrolled 3763 patients who received revascularization therapy during two distinct pesiod.Our study included 670 CHD patients from the whole DESIRE population who received revascularization during July 2003 to June 2004 and comorbid with diabetes mellitus.According to the revasularizaton strategy,the patients were divided into the PCI group(n=400) and the CABG group(n=270).Adverse cardiac and vascular events were the composite endpoints which included all-cause of death,non-fatal myocardial infarction,non-fatal stroke and revascularization.Results Baseline data had no difference between the two groups.In-hospital adverse cardiac events in the PCI group was fewer than in the CABG group(0.5% vs 4.1%,P=0.001) as shown by a lower mortality in the PCI group compared with the CABG group(0.5% vs 3.3%,P=0.012).Duration of follow-up in the PCI group and the CABG group was 592.6?121.3 days and 581.5?148.3 days respectively.The incidence s of long-term adverse cardiac events had no differnce between the two groups,but an increase trend was observed in the PCI group compared with the CABG group(14.2% vs 9.0%,P=0.056),owing to a higher percentage of revascularization(8.5% vs 2.1%,P=0.001).Two groups had a similar incidence of death,non-fatal myocardial infarction,non-fatal stroke during the follow-up period.Conclusion With the wide-spread of DES application,in-hospital adverse cardiac events in the PCI group was fewer than in the CABG group especially in terms of mortality.Long-term adverse cardiac events had no differnce between two groups,but PCI group had more revascularization.