Outcomes of Myocardial Revascularization in Diabetic Patients With Left Main Coronary Artery Disease: A Multicenter Observational Study From Three Gulf Countries.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Daoulah Amin, Elfarnawany Amr, Al Garni Turki, Hersi Ahmad S, Alshehri Mohammed, Almahmeed Wael, Yousif Nooraldaem, Abuelatta Reda, Alasmari Abdulaziz, Elsheikh-Mohamed Nezar Essam, Alzahrani Badr, Ghani Mohamed Ajaz, Amin Haitham, Hashmani Shahrukh, Hiremath Niranjan, Alshali Khalid Z, Elmahrouk Youssef, Kazim Hameedullah M, Refaat Wael, Selim Ehab, Jamjoom Ahmed, Feteih Maun N, El-Sayed Osama, Al-Faifi Salem M, Dahdouh Ziad, Aithal Jairam, Ibrahim Ahmed M, Elganady Abdelmaksoud, Qutub Mohammed A, Alama Mohamed N, Abohasan Abdulwali, Hassan Taher, Balghith Mohammed, Hussien Adnan Fathey, Abdulhabeeb Ibrahim A M, Ahmad Osama, Ramadan Mohamed, Alqahtani Abdulrahman H, Abumelha Bader K, Qenawi Wael, Shawky Ahmed, Ghonim Ahmed A, Elmahrouk Ahmed, Alhamid Sameer, Maghrabi Mohamed, Haddara Mamdouh M, Aljohar Alwaleed, Hurley William T, Alshahrani Saif S, Lotfi Amir
Аннотация
METHODS: We retrospectively studied patients with LMCA presented to 14 centers from 2015 to 2019. The study included 2138 patients with unprotected LMCA disease; 1468 (68.7 %) had diabetes. Patients were grouped into; diabetes with PCI (n = 804) or CABG (n = 664) and non-diabetes with PCI (n = 418) or CABG (n = 252).
RESULTS: In diabetes, cardiac (34 (5.1 %) vs. 22 (2.7 %); P = 0.016), non-cardiac (13 (2 %) vs. 6 (0.7 %); P = 0.027) and total hospital mortality (47 (7.1 %) vs. 28 (3.5 %); P = 0.0019), myocardial infarction (45 (6.8 %) vs. 11 (1.4 %); P = 0.001), cerebrovascular events (25 (3.8 %) vs. 12 (1.5 %); P = 0.005) and minor bleeding (65 (9.8 %) vs. 50 (6.2 %); P = 0.006) were significantly higher in CABG patients compared to PCI; respectively. The median follow-up time was 20 (10-37) months. In diabetes, total mortality was higher in CABG (P = 0.001) while congestive heart failure was higher in PCI (P = 0.001). There were no differences in major adverse cerebrovascular events and target lesion revascularization between PCI and CABG. Predictors of mortality in diabetes were high anatomical SYNTAX, peripheral arterial disease, chronic kidney disease, and cardiogenic shock.
CONCLUSIONS: In this multicenter retrospective study, we found no significant difference in clinical outcomes during the short-term follow-up between PCI with second-generation DES and CABG except for lower total mortality and a higher rate of congestive heart failure in PCI group of patients. Randomized trials to characterize patients who could benefit from each treatment option are needed.