PMID- 29861270
OWN - NLM
STAT- MEDLINE
DCOM- 20191210
LR  - 20191217
IS  - 1879-1484 (Electronic)
IS  - 0021-9150 (Linking)
VI  - 277
DP  - 2018 Oct
TI  - Impact of treatment strategies on outcomes in patients with stable coronary 
      artery disease and type 2 diabetes mellitus according to presenting angina 
      severity: A pooled analysis of three federally-funded randomized trials.
PG  - 186-194
LID - S0021-9150(18)30179-5 [pii]
LID - 10.1016/j.atherosclerosis.2018.04.005 [doi]
AB  - BACKGROUND AND AIMS: The impact of treatment strategies on outcomes in patients 
      with stable coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM) 
      according to presenting angina has not been rigorously assessed. METHODS: We 
      performed a patient-level pooled-analysis (n = 5027) of patients with stable CAD 
      and T2DM randomized to optimal medical therapy [OMT], percutaneous coronary 
      intervention [PCI] + OMT, or coronary artery bypass grafting [CABG] + OMT. 
      Endpoints were death/myocardial infarction (MI)/stroke, post-randomization 
      revascularization (both over 5 years), and angina control at 1 year. RESULTS: 
      Increasing severity of baseline angina was associated with higher rates of 
      death/MI/stroke (p = 0.009) and increased need for post-randomization 
      revascularization (p = 0.001); after multivariable adjustment, only association 
      with post-randomization revascularization remained significant. Baseline angina 
      severity did not influence the superiority of CABG + OMT to reduce the rate of 
      death/MI/stroke and post-randomization revascularization compared to other 
      strategies. CABG + OMT was superior for angina control at 1 year compared to both 
      PCI + OMT and OMT alone but only in patients with >/= Class II severity at 
      baseline. Comparisons between PCI + OMT and OMT were neutral except that 
      PCI + OMT was superior to OMT for reducing the rate of post-randomization 
      revascularization irrespective of presenting angina severity. CONCLUSIONS: 
      Presenting angina severity did not influence the superiority of CABG + OMT with 
      respect to 5-year rates of death/MI/stroke and need for post-randomization 
      revascularization. Presenting angina severity minimally influenced relative 
      benefits for angina control at 1 year.
CI  - Copyright (c) 2018 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Mancini, G B John
AU  - Mancini GBJ
AD  - University of British Columbia, Vancouver, British Columbia, Canada. Electronic 
      address: mancini@mail.ubc.ca.
FAU - Boden, William E
AU  - Boden WE
AD  - Clinical Trials Network and Massachusetts Veterans Epidemiology, Research, and 
      Informatics Center (MAVERIC), Veterans Affairs New England Healthcare System, 
      Boston, MA, United States.
FAU - Brooks, Maria M
AU  - Brooks MM
AD  - University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, 
      United States.
FAU - Vlachos, Helen
AU  - Vlachos H
AD  - University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, 
      United States.
FAU - Chaitman, Bernard R
AU  - Chaitman BR
AD  - St. Louis University School of Medicine, St. Louis, Missouri, United States.
FAU - Frye, Robert
AU  - Frye R
AD  - Mayo Clinic, Rochester, MN, United States.
FAU - Bittner, Vera
AU  - Bittner V
AD  - University of Alabama at Birmingham, Birmingham, AL, United States.
FAU - Hartigan, Pamela M
AU  - Hartigan PM
AD  - West Haven Veterans Administration Coordinating Center, West Haven, CT, United 
      States.
FAU - Dagenais, Gilles R
AU  - Dagenais GR
AD  - Quebec Heart and Lung University Institute, Quebec City, Quebec, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180601
PL  - Ireland
TA  - Atherosclerosis
JT  - Atherosclerosis
JID - 0242543
RN  - 0 (Cardiovascular Agents)
SB  - IM
CIN - Atherosclerosis. 2018 Oct;277:169-171. PMID: 29764694
MH  - Aged
MH  - Angina Pectoris/diagnosis/epidemiology/*therapy
MH  - Cardiovascular Agents/adverse effects/*therapeutic use
MH  - *Coronary Artery Bypass/adverse effects/mortality
MH  - Coronary Artery Disease/diagnosis/epidemiology/*therapy
MH  - Diabetes Mellitus, Type 2/diagnosis/*epidemiology/mortality
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/therapy
MH  - *Percutaneous Coronary Intervention/adverse effects/mortality
MH  - Randomized Controlled Trials as Topic
MH  - Retreatment
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke/mortality/therapy
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - CCS angina classification
OT  - Coronary artery bypass grafting
OT  - Optimal medical therapy
OT  - Percutaneous coronary intervention
OT  - Stable ischemic heart disease
OT  - Type 2 diabetes mellitus
EDAT- 2018/06/05 06:00
MHDA- 2019/12/18 06:00
CRDT- 2018/06/05 06:00
PHST- 2018/03/07 00:00 [received]
PHST- 2018/03/27 00:00 [revised]
PHST- 2018/04/06 00:00 [accepted]
PHST- 2018/06/05 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2018/06/05 06:00 [entrez]
AID - S0021-9150(18)30179-5 [pii]
AID - 10.1016/j.atherosclerosis.2018.04.005 [doi]
PST - ppublish
SO  - Atherosclerosis. 2018 Oct;277:186-194. doi: 
      10.1016/j.atherosclerosis.2018.04.005. Epub 2018 Jun 1.