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Comparative Study
. 2016 Sep;31(9):1424-9.
doi: 10.1007/s00380-015-0746-1. Epub 2015 Sep 28.

Comparing mortality between coronary artery bypass grafting and percutaneous coronary intervention with drug-eluting stents in elderly with diabetes and multivessel coronary disease

Ryo Naito  1 , Katsumi Miyauchi  2 , Hirokazu Konishi  1 , Shuta Tsuboi  1 , Manabu Ogita  1 , Tomotaka Dohi  1 , Kan Kajimoto  3 , Takatoshi Kasai  1 , Hiroshi Tamura  1 , Shinya Okazaki  1 , Kikuo Isoda  1 , Taira Yamamoto  3 , Atsushi Amano  3 , Hiroyuki Daida  1
Affiliations
Comparative Study

Comparing mortality between coronary artery bypass grafting and percutaneous coronary intervention with drug-eluting stents in elderly with diabetes and multivessel coronary disease

Ryo Naito et al. Heart Vessels. 2016 Sep.

Abstract

Coronary artery disease is a critical issue that requires physicians to consider appropriate treatment strategies, especially for elderly people who tend to have several comorbidities, including diabetes mellitus (DM) and multivessel disease (MVD). Several studies have been conducted comparing clinical outcomes between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) in patients with DM and MVD. However, elderly people were excluded in those clinical studies. Therefore, there are no comparisons of clinical outcomes between CABG and PCI in elderly patients with DM and MVD. We compared all-cause mortality between PCI with drug-eluting stents (DES) and CABG in elderly patients with DM and MVD. A total of 483 (PCI; n = 256, CABG; n = 227) patients were analyzed. The median follow-up period was 1356 days (interquartile range of 810-1884). The all-cause mortality rate was not significantly different between CABG and PCI with DES groups. The CABG group had more patients with complex coronary lesions such as three-vessel disease or a left main trunk lesion. Older age, hemodialysis, and reduced LVEF were associated with increased long-term all-cause mortality in a multivariable Cox regression analysis. The rate of all-cause mortality was not significantly different between the PCI and CABG groups in elderly patients with DM and MVD in a single-center study.

Keywords: Coronary artery bypass graft; Diabetes mellitus; Elderly; Multivessel disease; Percutaneous coronary intervention.

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Conflict of interest statement

All authors declare no conflict of interest related to this work.

Figures

Fig. 1
Fig. 1
All-cause mortality rate was 12.1 and 16.3 % in PCI- and CABG-treated groups, respectively. Cardiovascular mortality rate was 3.1 and 2.2 % in PCI- and CABG-treated groups, respectively
Fig. 2
Fig. 2
Cumulative event-free survival curves for all-cause mortality. Kaplan–Meier curves for all-cause mortality show no significant difference between PCI- and CABG-treated groups, respectively
See this image and copyright information in PMC

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