Among diabetics with left main CAD, PCI associated with increased risk of CHF: Study
CAPTION
Aspirin should be favoured over warfarin to prevent blood clotting in children who undergo a surgery that replumbs their hearts, according to a new study.
CREDIT
jesse orrico
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Dr Amin Daoulah and team have found in a new study that Among diabetes patients with left main CAD, there was no significant difference in clinical outcomes during the short-term follow-up between PCI with second-generation DES and CABG. However in PCI group of patients the total mortality was lower but there was a higher rate of congestive heart failure.
The findings of this study were published in Cardiovascular Revascularization Medicine.
There are few real-world examples of how to treat people with diabetes and left main coronary artery (LMCA) illness. In order to assess the effectiveness of percutaneous coronary intervention against coronary artery bypass grafting in individuals with diabetes and LMCA disease, this study was carried out.
Researchers looked back at LMCA patients who had been seen in 14 centers between 2015 and 2019 for this study. 1468 (68.7%) of the 2138 individuals with unprotected LMCA illness in the study had diabetes. Patients were divided into two groups: those with diabetes and PCI or CABG (n = 804) or without diabetes and PCI or CABG (n = 252) (n = 418).
The key findings of this study were as follows:
1. Diabetes patients undergoing CABG had considerably greater rates of myocardial infarction, non-cardiac and total hospital mortality, cerebrovascular events, and mild bleeding than those undergoing PCI.
2. The typical follow-up period was 20 months (10–37) where, congestive heart failure was more common with PCI group.
3. Total mortality with diabetes was greater with CABG.
4. Target lesion revascularization and significant adverse cerebrovascular events between PCI and CABG were comparable.
5. Peripheral arterial disease, high anatomical SYNTAX, chronic renal disease, and cardiogenic shock were all predictors of mortality in diabetes.
In conclusion, at a median follow-up of 20 months, we found no statistically significant differences in clinical outcomes between PCI with second-generation DES and CABG in this retrospective study of diabetic patients, with the exception of lower total mortality and a higher rate of congestive heart failure in the PCI group of patients. Randomized trials are required to identify the patients who might benefit from each therapy option added the Authors.
Reference:
Daoulah, A., Elfarnawany, A., Al Garni, T., Hersi, A. S., Alshehri, M., Almahmeed, W., Yousif, N., Abuelatta, R., Alasmari, A., Elsheikh-Mohamed, N. E., Refaat, W., … Lotfi, A. (2022). Outcomes of myocardial revascularization in diabetic patients with left main coronary artery disease: A multicenter observational study from three gulf countries. In Cardiovascular Revascularization Medicine. Elsevier BV. https://doi.org/10.1016/j.carrev.2022.08.002
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