PMID: 9426011Jan 13, 1998Paper

Outcome of coronary bypass surgery versus coronary angioplasty in diabetic patients with multivessel coronary artery disease

Journal of the American College of Cardiology
W S WeintraubS B King

Abstract

This study sought to compare the outcome of percutaneous transluminal coronary angioplasty (PTCA) (n = 834) and coronary artery bypass graft surgery (CABG) (n = 1805) in diabetic patients with multivessel coronary disease from an observational database. There is concern about selection of revascularization in diabetic patients with multivessel coronary artery disease. Data were collected prospectively and entered into a computerized database. Follow-up was by letter or telephone or additional events resulting in readmission. After CABG there were more in-hospital deaths (0.36% vs. 4.99%, p < 0.0001) and a trend toward more Q wave myocardial infarctions than after PTCA. Five- and 10-year survival rates were 78% and 45% after PTCA and 76% and 48% after CABG, respectively (p = 0.47). At 5 and 10 years, insulin-requiring patients had lower survival rates of 72% and 31% after PTCA and 70% and 48% after CABG, respectively (p = 0.54). Multivariate correlates of long-term mortality were older age, low left ventricular ejection fraction, heart failure and hypertension. In the total group, insulin requirement was a correlate of long-term mortality. For the total group, choice of therapy had a multivariate hazard ratio close to 1. In the ...Continue Reading

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