P3591Very long-term follow-up of diabetic patients with coronary artery disease undergoing angioplasty with conventional and drug-eluting stents

Approximately 2% of the total healthcare expenditure in the European Union is spent on coronary artery disease and these expenditures are expected to increase. In order to make rational decisions on resource allocation, clinical and economic outcomes of treatment strategies need to be analysed together. Cost-effectiveness studies provide a framework for making such decisions. The early economic studies comparing balloon angioplasty with coronary artery bypass grafting (CABG) show that the early cost benefit of angioplasty is lost at long-term follow-up. CABG provides a clinically and economically attractive treatment option in patients with severe coronary artery disease. Later studies with bare-metal or drug eluting stents showed that the higher invasiveness of CABG leads to a longer hospital stay and higher upfront costs. However, at longer follow-up the cost difference is small and clinical outcomes with CABG are better than with percutaneous coronary intervention (PCI). This makes CABG superior to PCI at long-term follow-up, both clinically and economically in patients with extensive coronary disease. Nevertheless, in patients with less complex coronary artery disease, PCI with drug-eluting stents may be preferred on both clinical and economic grounds. Although reduction in stent price does not have a big impact, several other developments may impact future economic comparisons between PCI and CABG. Newer-generation stents will enhance the clinical and economic profile of PCI. Moreover, better clinical decision-making tools and fractional flow reserve will impact the cost-effectiveness equation.

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P2265Impact of glycated hemoglobin in diabetic patients with coronary artery disease undergoing surgery, angioplasty or clinical treatment in a very long-term follow-up

European Heart Journal ◽

10.1093/eurheartj/ehy565.p2265 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

J P P Linhares Filho ◽

W Hueb ◽

D V Batista ◽

R R Silva ◽

E G Lima ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Glycated Hemoglobin ◽

Clinical Treatment ◽

Diabetic Patients ◽

Long Term Follow Up ◽

Artery Disease

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Long-term efficacy and safety of drug-coated balloons versus drug-eluting stents for small coronary artery disease (BASKET-SMALL 2): 3-year follow-up of a randomised, non-inferiority trial

The Lancet ◽

10.1016/s0140-6736(20)32173-5 ◽

2020 ◽

Vol 396 (10261) ◽

pp. 1504-1510 ◽

Cited By ~ 2

Author(s):

Raban V Jeger ◽

Ahmed Farah ◽

Marc-Alexander Ohlow ◽

Norman Mangner ◽

Sven Möbius-Winkler ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Drug Eluting Stents ◽

Efficacy And Safety ◽

Term Efficacy ◽

Drug Eluting ◽

Artery Disease

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Long-term follow-up of first generation versus new-generation drug-eluting stents in three-vessel coronary artery disease

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2017.04.006 ◽

2017 ◽

Vol 18 (7) ◽

pp. 492-496 ◽

Cited By ~ 5

Author(s):

Toru Yoshizaki ◽

Toru Naganuma ◽

Tsuyoshi Kobayashi ◽

Takeo Horikoshi ◽

Hirokazu Onishi ◽

...

Keyword(s):

Coronary Artery Disease ◽

First Generation ◽

Drug Eluting Stents ◽

Long Term Follow Up ◽

Drug Eluting ◽

Artery Disease ◽

New Generation ◽

Vessel Coronary Artery

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Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

Journal of Diabetes Research ◽

10.1155/2019/6036359 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Joanna Wojtasik-Bakalarz ◽

Zoltan Ruzsa ◽

Tomasz Rakowski ◽

Andreas Nyerges ◽

Krzysztof Bartuś ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Risk Of Death ◽

Significant Difference ◽

Long Term Follow Up ◽

Artery Disease ◽

The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

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