CABG May Be Best for Multivessel Revascularization in T1DM

Increased risks of coronary heart disease mortality, MI, repeat revascularization with PCI


WEDNESDAY, Aug. 30, 2017 (HealthDay News) -- For patients with type 1 diabetes (T1D) undergoing a first multivessel revascularization, percutaneous coronary intervention (PCI) is associated with increased risks of coronary heart disease mortality, myocardial infarction, and repeat revascularization, compared with coronary artery bypass grafting (CABG), according to a study published online Aug. 26 in the Journal of the American College of Cardiology. The research was published to coincide with the European Society of Cardiology Congress 2017, held from Aug. 26 to 30 in Barcelona, Spain.

Thomas Nyström, M.D., Ph.D., from the Karolinska Institutet in Stockholm, and colleagues conducted an observational cohort study involving patients with T1D who underwent a first multivessel revascularization from 1995 to 2013 (683 patients who underwent CABG and 1,863 who underwent PCI).

The researchers found that 53 percent of patients in the CABG group and 45 percent in the PCI group died during a mean follow-up of 10.6 years. Compared with CABG, PCI was associated with similar risks of all-cause mortality (hazard ratio, 1.14; 95 percent confidence interval, 0.99 to 1.32), and with elevated risks of coronary heart disease mortality (hazard ratio, 1.45; 95 percent confidence interval, 1.21 to 1.74), myocardial infarction (hazard ratio, 1.47; 95 percent confidence interval, 1.23 to 1.78), and repeat revascularization (hazard ratio, 5.64; 95 percent confidence interval, 4.67 to 6.82). There were no differences noted in the risks for stroke or heart failure.

"CABG may be the preferred strategy in patients with T1D in need of multivessel revascularization," the authors write.

One author disclosed financial ties to Actelion and Pfizer.

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