scholarly journals Long-Term Effect of Ultrathin-Strut Versus Thin-Strut Drug-Eluting Stents in Patients With Small Vessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

2019 ◽  
Vol 12 (8) ◽  
Author(s):  
Juan F. Iglesias ◽  
Dik Heg ◽  
Marco Roffi ◽  
David Tüller ◽  
Stéphane Noble ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Intervention ◽  
Term Effect ◽  
Drug Eluting Stents ◽  
Long Term Effect ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Artery Disease ◽  
Vessel Coronary Artery

Real-world referral pattern and outcomes of diabetic patients who undergo revascularization: data from the prospective Multi-vessel Coronary Artery Disease (MULTICAD) Israeli Registry†

2019 ◽  
Vol 56 (2) ◽  
pp. 328-334 ◽  
Author(s):  
Eilon Ram ◽  
Ilan Goldenberg ◽  
Leonid Sternik ◽  
Yael Peled ◽  
Amit Segev ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Term Survival ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Percutaneous Revascularization ◽  
Vessel Coronary Artery

Abstract OBJECTIVES Diabetes mellitus patients with multivessel coronary artery disease present with a poor prognosis. We aimed to explore real-life clinical outcomes of diabetic patients who were referred for coronary revascularization. METHODS We used data from the Multi-vessel Coronary Artery Disease (MULTICAD) Israeli Registry. Using descriptive statistics, Kaplan–Meier, Cox and logistic regression, we described a revascularization referral pattern, short-term outcomes and long-term survival among 475 diabetic patients with multivessel and/or left main disease, 48% of whom underwent surgical and 52% percutaneous revascularization. RESULTS Factors independently associated with referral for surgery included the presence of left main stenosis [odds ratio (OR) 1.89; P = 0.030] and a higher Syntax score (OR 1.15 per point increment; P < 0.001), whereas an older age (OR 1.03 per 1-year increment in age; P = 0.019), prior percutaneous coronary intervention (OR 1.83; P = 0.009) and the presence of renal impairment (OR 2; P = 0.026) were associated with percutaneous coronary intervention referral. At 7 months of follow-up, multivariable analysis did not reveal any difference in mortality risk between the surgical and percutaneous revascularization groups [hazard ratio (HR) 1.23, 95% confidence interval (CI) 0.5–3.04; P = 0.649], whereas after 7 months, surgical revascularization was associated with a significant survival benefit (HR 2.24, 95% CI 1.03–4.87; P = 0.042). CONCLUSIONS Our observation suggests that in a real-world setting, only approximately one-half of diabetic patients with multivessel disease are referred to surgical revascularization despite guideline indications. Surgical compared to percutaneous revascularization in this population was associated with improved long-term survival that became evident 7 months after the revascularization procedure.

Sign in / Sign up

Export Citation Format

Share Document