Percutaneous Coronary Intervention Raises Risk for Adverse Outcomes in Diabetes

(HealthDay News) — For adults with diabetes and multivessel or left main coronary artery disease (CAD), percutaneous coronary intervention (PCI) is associated with increased likelihood of a composite outcome compared with coronary artery bypass grafting (CABG), according to a review and meta-analysis published in the Annals of Internal Medicine.

Benny Tu, MBBS, from the University of Queensland in Brisbane, Australia, and colleagues compared long-term outcomes between the revascularization techniques of PCI and CABG in patients with diabetes. Data were obtained from 40 studies involving adults with diabetes with multivessel or left main CAD.

The likelihood of the primary outcome — a composite of all-cause mortality, nonfatal myocardial infarction (MI) and stroke — increased with PCI (OR=1.33; 95% credible interval [CrI], 1.01-1.65). 

Mortality was increased significantly with PCI (OR=1.44; 95% CrI, 1.05-1.91), while there was no change in the number of MIs (OR=1.33; 95% CrI, 0.86-1.95) and the likelihood of stroke decreased (OR=0.56; 95% CrI, 0.36- 0.88).

“Because of residual uncertainties and increased risk for stroke with CABG, clinical judgment is required when choosing a revascularization technique in patients with diabetes,” the researchers wrote.

Reference

  1. Tu B et al. Ann Intern Med. 2014;161(10):724-732.