Among diabetics with left main CAD, PCI associated with increased risk of CHF: Study

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