CABG Appears Superior to PCI for Patients With Type 1 Diabetes, Multivessel Disease
The observational findings support existing recommendations favoring surgical revascularization in patients with diabetes.
BARCELONA, Spain—Over the long term, patients with type 1 diabetes and multivessel coronary disease fare better with CABG than with PCI, a population-based cohort study suggests.
Those findings, reported by Martin Holzmann, MD, PhD (Karolinska University Hospital, Stockholm, Sweden), at the European Society of Cardiology Congress 2017 here and published simultaneously online in the Journal of the American College of Cardiology, are consistent with both US and European guidelines, which recommend surgical revascularization over PCI in patients with diabetes.
“Our findings indicate that for patients with type 1 diabetes, CABG instead of PCI should be the preferred strategy for multivessel revascularization,” Holzmann said during his presentation.
Even so, he and his colleagues say in the paper that their “findings should be interpreted with some caution because of the observational nature of the study, and maybe more importantly, the large differences in risks in the first year of follow-up, indicating that there were large inherent differences in risk at baseline between the PCI and CABG groups.”
CABG has consistently been shown to improve outcomes over PCI in patients with diabetes—in the BARI and FREEDOM trials and in a subgroup analysis of the SYNTAX trial, for instance. But Holzmann noted that none of those studies has performed subgroup analyses based on the type of diabetes; this could be important when considering the findings because Continue reading