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To investigate the long term clinical outcomes of diabetic patients with prior CABG who underwent secondary PCI of either a graft vessel (GV), a native coronary vessel (NV).
157 patients with diabetes and previous CABG, who underwent PCI of either a graft (n=44) or a native (n=113) vessel, were studied. All stents implanted were drug eluting stents (DES). The median follow-up was 45 months.
Group GV patients compared with group NV had more totally occluded native vessels, less totally occluded grafts. Group GV patients had a lower TIMI flow grade pre PCI compared with Group NV. However, there was no difference in TIMI flow grade post PCI between two groups. 39 patients had MACE and there were 12 total deaths; 2 in graft-PCI group and 10 in the native PCI group (P=0.51). There were 22 TVR and 8 MI without significant difference between the two groups. Cox regression analysis showed that PCI success (OR 11.488, 95% CI 1.135-116.303, P<0.05) were independent predictors of MACE.
It suggests the similar long-term clinical outcomes after PCI in GV or NV in prior CABG patients with diabetes. Thus the vessel with higher estimated PCI success rate should be preferred.