Comparison between coronary artery bypass surgery and percutaneous coronary intervention with drug-eluting stents for Egyptian diabetic patients with Multivessel disease

ABSTRACT Background: With the advances in the interventional field, the usage of DES make the choice of revascularization in diabetic patients with MVD controversial. Methods: We assigned patients with diabetes and MVD to undergo either PCI with DES or CABG. The patients were followed up for 12 months. The primary outcome was a composite of death, MI, repeated revascularization or stroke. Results: The study was conducted on 225 patients (116 patients randomly assigned to the PCI group and 109 randomly assigned to the CABG group), 159 males (70.6%), 66 female (29.4%) and their mean age was 57.08±5.79. The mean HbA1c was 7.35%, the mean SYNTAX Score was 24.71, and the mean EuroScore II was 1.04%. No significant differences were seen between CABG and PCI groups in the occurrence of MI at 30 days and 12 months (P = 0.839 and 0.533 respectively), post procedure stroke at 30 days and 12 months (P = 0.234 and 0.612 respectively), for repeated revascularization at 30 days (P = 0.282) and for death at 30 days and 12 months (P = 0.234 and 0.612 respectively). However repeated revascularization after 12 months was significantly higher in PCI with DES group (14 (12.1%) vs 5 (4.6%) patients with P = 0.044). Conclusions: Diabetic patients with multivessel CAD, comparison between CABG and PCI with DES showed similar mortality, post procedure MI and stroke. However PCI was associated with increased rate of repeat revascularization after 12 months. Diabetes mellitus, multivessel disease. 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