PMID- 34089266
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 44
IP  - 7
DP  - 2021 Jul
TI  - Percutaneous coronary intervention versus coronary artery bypass grafting in 
      patients with coronary heart disease and type 2 diabetes mellitus: Cumulative 
      meta-analysis.
PG  - 899-906
LID - 10.1002/clc.23613 [doi]
AB  - Previous meta-analyses showed that coronary artery bypass grafting (CABG) has 
      lower all-cause mortality than percutaneous coronary intervention (PCI) for the 
      management of coronary heart disease (CHD), but the long-term outcomes were not 
      analyzed thoroughly in patients with type 2 diabetes mellitus (T2DM). To perform 
      a meta-analysis of randomized controlled trials (RCTs) to explore the long-term 
      effectiveness between CABG and PCI in patients with T2DM and study the temporal 
      trends using a cumulative meta-analysis. PubMed, Embase, Cochrane library, and 
      Clinical Trials Registry for eligible RCTs published up to September 2020. The 
      outcomes were all-cause death, cardiac death, myocardial infarction, repeat 
      revascularization, and stroke. Nine RCTs and 4566 patients were included. CABG 
      resulted in better outcomes than PCI in terms of all-cause death (RR = 1.41, 
      95%CI: 1.22-1.63, p < 0.001), cardiac death (RR = 1.56, 95%CI: 1.25-1.95, 
      p < 0.001), and repeat revascularization (RR = 2.68, 95%CI: 1.86-3.85, 
      p < 0.001), but with difference regarding the occurrence of myocardial infarction 
      (RR = 1.20, 95%CI: 0.78-1.85, p = 0.414), while PCI was associated with better 
      outcomes in terms of stroke occurrence (RR = 0.51, 95%CI: 0.34-0.77, p = 0.001). 
      The cumulative meta-analysis for all-cause death showed that the differences 
      between CABG and PCI started to be significant at 3 years of follow-up, while the 
      difference became significant at 5 years for cardiac death. In patients with CHD 
      and T2DM, CABG results in better outcomes than PCI in terms of all-cause death, 
      cardiac mortality, and repeat revascularization, while PCI had better outcomes in 
      terms of stroke. The differences are mainly observed over the long-term 
      follow-up.
CI  - (c) 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
FAU - Xie, Qiuping
AU  - Xie Q
AUID- ORCID: 0000-0003-4697-8138
AD  - Department of Cardiology, Zhuzhou Central Hospital, Zhuzhou, China.
FAU - Huang, Jianguo
AU  - Huang J
AD  - Department of Cardiology, Liling Traditional Chinese Medicine Hospital, Zhuzhou, 
      China.
FAU - Zhu, Ke
AU  - Zhu K
AD  - Department of Cardiology, Zhuzhou Central Hospital, Zhuzhou, China.
FAU - Chen, Qing
AU  - Chen Q
AD  - Department of Cardiology, Zhuzhou Central Hospital, Zhuzhou, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20210605
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Coronary Artery Bypass
MH  - *Coronary Artery Disease/diagnosis/surgery
MH  - *Diabetes Mellitus, Type 2/complications/diagnosis
MH  - Humans
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Treatment Outcome
PMC - PMC8259162
OTO - NOTNLM
OT  - coronary artery bypass graft
OT  - coronary heart disease
OT  - meta-analysis
OT  - mortality
OT  - percutaneous coronary intervention
OT  - type 2 diabetes mellitus
COIS- The authors declare no potential conflict of interest.
EDAT- 2021/06/06 06:00
MHDA- 2021/10/16 06:00
PMCR- 2021/06/05
CRDT- 2021/06/05 08:33
PHST- 2021/04/07 00:00 [revised]
PHST- 2021/01/20 00:00 [received]
PHST- 2021/04/16 00:00 [accepted]
PHST- 2021/06/06 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/06/05 08:33 [entrez]
PHST- 2021/06/05 00:00 [pmc-release]
AID - CLC23613 [pii]
AID - 10.1002/clc.23613 [doi]
PST - ppublish
SO  - Clin Cardiol. 2021 Jul;44(7):899-906. doi: 10.1002/clc.23613. Epub 2021 Jun 5.