Coronary artery bypass surgery compared with percutaneous
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Coronary artery bypass surgery compared with percutaneous
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Cardiovascular Diabetology
Bundhun et al. Cardiovasc Diabetol (2016) 15:2 DOI 10.1186/s12933-015-0323-z
Open Access
ORIGINAL INVESTIGATION
Coronary artery bypass surgery compared with percutaneous coronary interventions in patients with insulin‑treated type 2 diabetes mellitus: a systematic review and meta‑analysis of 6 randomized controlled trials Pravesh Kumar Bundhun, Zi Jia Wu and Meng‑Hua Chen*
Abstract Background: Data regarding the long-term clinical outcomes in patients with insulin-treated type 2 diabetes melli‑ tus (ITDM) revascularized by either coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) are still controversial. We sought to compare the long-term (≥1 year) adverse clinical outcomes in patients with ITDM who underwent revascularization by either CABG or PCI. Methods: Randomized Controlled Trials (RCTs) comparing the long-term clinical outcomes in patients with ITDM and non-ITDM revascularized by either CABG or PCI were searched from electronic databases. Data for patients with ITDM were carefully retrieved. Odd Ratio (OR) with 95 % confidence interval (CI) was used to express the pooled effect on discontinuous variables and the pooled analyses were performed with RevMan 5.3. Results: Six RCTs involving 10 studies, with a total of 1297 patients with ITDM were analyzed (639 patients from the CABG group and 658 patients from the PCI group). CABG was associated with a significantly lower mortality rate compared to PCI with OR: 0.59, 95 % CI 0.42–0.85; P = 0.004. Major adverse cardiovascular and cerebrovascular events as well as repeated revascularization were also significantly lower in the CABG group with OR: 0.51, 95 % CI 0.27–0.99; P = 0.03 and OR 0.34, 95 % CI 0.24–0.49; P
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