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Percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in the treatment of diabetic patients with multi-vessel coronary disease: A meta-analysis
Diabetes Research and Clinical Practice, 08/21/2012
Evidence Based Medicine
Clinical Article
Zhang F et al. – In diabetic patients with multi–vessel coronary disease, CABG was not only more effective than PCI in reducing mortality but also led to fewer repeated revascularizations and fewer major adverse cardiac and cerebrovascular events. Despite these benefits, CABG did put diabetic patients at higher risk for cerebrovascular accident than PCI.
Methods- Nine randomized controlled trials were identified in which a total of 1047 diabetic patients were randomly assigned to PCI and 1054 to CABG.
- Results showed that five–year mortality was significantly higher in diabetic patients after PCI than after CABG (risk difference (RD) of 7%; P<0.001); repeated revascularization was more common after PCI than after CABG (one–year RD of 13%; P<0.001); major adverse cardiac and cerebrovascular events were also more frequent after PCI (one–year RD of 12%; P<0.001); however, the cerebrovascular accident rate was lower in the PCI group than the CABG group (one–year RD of –2%; P=0.004).