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The purpose of this study was to evaluate the outcome of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in patients who had multi-vessel coronary artery disease with or without diabetes mellitus.
This is a multicenter, retrospective trial to assess the outcome of the CABG and PCI in patients who had multi-vessel coronary artery disease with or without diabetes mellitus between January 2003 and December 2011.
The primary outcome is major adverse cardiac and cerebrovascular events (MACCE=all-cause mortality, myocardial infarction, stroke or re-revascularization).
Patients with multi-vessel disease were divided in diabetic group (n=662, 29.9%) and non-diabetic group (n=1549, 70.1%). The rates of all-cause mortality of diabetic group and non-diabetic group were 6.0%（n=40), 4.3% (n=67), P=0.0911; The rates of MACCE were 13.3% (n=88), 9.06%(n=139) P=0.0027.The incidence of MACCE was significantly higher in diabetic patients than those of non-diabetic patients (OR 1.555，95%CI 1.114-2.169，P=0.0094), the incidence of all-cause mortality in diabetic group was similar to that of non-diabetic group (OR 1.176，95%CI 0.665-2.082，P=0.5769).
Among diabetic patients, the rates of all-cause mortality of PCI, CABG were 6.9% (n=35), 3.3% (n=5), P=0.0800; The rates of MACCE were 14.1% (n=72), 10.5%(n=16), P=0.22787. The incidence of all-cause mortality was significantly lower in CABG than in PCI (OR=0.069, 95% CI, 0.008-0.559 P=0.0123). The incidence of MACCE in CABG was similar to that of PCI(OR=1.641, 95% CI, 0.32-1.284 P=0.2093).
Coronary revascularization with CABG surgery is the treatment of choice in diabetic patients with multi-vessel coronary artery disease.
Diabetes was the independent risk factor of MACCE in patients, who had multi-vessel coronary artery disease,