Outcomes of Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention in Patients Aged 18–45 Years with Diabetes Mellitus
| Autor: | Hong-Jia Zhang, Ran Dong, Taoshuai Liu, Yang Li, Ning Zhou, Shao-You Zhou, Kun Hua |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment lcsh:Medicine Coronary Artery Disease 030204 cardiovascular system & hematology Coronary artery disease Angina 03 medical and health sciences Young Adult 0302 clinical medicine Percutaneous Coronary Intervention Internal medicine medicine Diabetes Mellitus Humans 030212 general & internal medicine Myocardial infarction cardiovascular diseases Coronary Artery Bypass Stroke Survival rate Coronary Artery Bypass Grafting business.industry lcsh:R Percutaneous coronary intervention Drug-Eluting Stents General Medicine Middle Aged medicine.disease Treatment Outcome surgical procedures operative Conventional PCI Propensity score matching Cardiology Female Original Article business |
| Zdroj: | Chinese Medical Journal, Vol 130, Iss 24, Pp 2906-2915 (2017) Chinese Medical Journal |
| ISSN: | 0366-6999 |
| Popis: | Background: Debate on treatment for young patients with coronary artery disease still exists. This study aimed to investigate the intermediate- and long-term outcomes between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients aged 18–45 years with diabetes mellitus (DM). Methods: Between January 2006 and March 2016, a total of 2018 DM patients aged 18–45 years including 517 cases of CABG and 1501 cases of PCI were enrolled in the study. Using propensity score matching (PSM), 406 patients were matched from each group. The intermediate- and long-term data were collected. The primary end point of this study was long-term death. The secondary end points included long-term major adverse cardiovascular and cerebrovascular events (MACCEs), stroke, angina, myocardial infarction (MI), and repeat revascularization. Results: Before PSM, the in-hospital mortality was 1.2% in the CABG group and 0.1% in the PCI group, with statistically significant difference (P < 0.0001). The 10-year follow-up outcomes including long-term survival rate and freedom from MACCEs were better in the CABG group than those in the PCI group (97.3% vs. 94.5%, P= 0.0072; 93.2% vs. 86.3%, P< 0.0001), but CABG group was associated with lower freedom from stoke compared to PCI group (94.2% vs. 97.5%, P= 0.0059). After propensity score-matched analysis, these findings at 10-year follow-up were also confirmed. Freedom from MACCEs was higher in CABG group compared to PCI group, but no significant difference was observed (93.1% vs. 89.2%, P= 0.0720). The freedom from recurrent MI was significantly higher in CABG patients compared with PCI patients (95.6% vs. 92.5%, P= 0.0260). Furthermore, CABG was associated with a higher rate of long-term survival rate than PCI (97.5% vs. 94.6%, P= 0.0403). There was no significant difference in the freedom from stroke between CABG and PCI groups (95.3% vs. 97.3%, P= 0.9385). The hospital cost was greater for CABG (13,936±4480 US dollars vs. 10,926±7376 US dollars, P< 0.0001). Conclusions: In DM patients aged 18–45 years, the cumulative survival rate, and freedom from MI and repeat revascularization for CABG were superior to those of PCI. However, a better trend to avoid stroke was observed with PCI. Key words: Coronary Artery Bypass Grafting; Coronary Artery Disease; Diabetes Mellitus; Percutaneous Coronary Intervention |
| Databáze: | OpenAIRE |
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