Drug Eluting Stents versus Coronary Artery Bypass Graft Surgery for Patients with Diabetes Mellitus and Multivessel Disease
Hesham Mohamed Abo-Elyazed
Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Khaled Abdel Salam Al-Sharnoubi
Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Taymour Mustafa Abdallah
Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mahmoud Zaki Al-Amrousy
Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: through coronary artery bypass graft (CABG) or through utilization of percutaneous coronary intervention (PCI) with stenting, coronary revascularization can be achieved. Diabetics represents a particularly challenging group for both treatments. This work aimed to estimate clinical outcome in diabetic individuals with multiple vessels disease (MVD) who had either PCI or CABG over 30 days.
Methods: This prospective research was conducted on 200 diabetic individuals with MVD established as severe stenosis. Into 2 equal groups, individuals were divided: Group (A) [underwent CABG], and group (B) [performed Drug Eluting Stents (DES) PCI]. All individuals underwent full history taking, resting twelve-leads electrocardiogram, complete clinical examination, transthoracic echocardiography, coronary angiographic, SYNTAX score and Euro score.
Results: In CABG group, age, statin, ACE-I/ARB, β- -blocker and dual antiplatelet therapy was significantly higher than PCI group. PCI group had significantly higher PCI, MI and repeated revascularization than the group of CABG. In PCI group, stroke and MI, death, myocardial infarction (MI), were significantly higher than in group of CABGS.
Conclusions: DES have developed for the coronary artery disease (CAD) treatment and are increasingly being utilized for complex CAD treatment, such as multivessel or left main CAD. PCI is preferred over CABG in high surgical risk individuals due to the shorter hospital stay, faster time of recovery, and potentially decreased stroke rate.
Keywords: Diabetes mellitus, DES, CABG surgery, PCI, multivessel disease
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Author Biographies
Hesham Mohamed Abo-Elyazed, Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Khaled Abdel Salam Al-Sharnoubi, Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Taymour Mustafa Abdallah, Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mahmoud Zaki Al-Amrousy, Department of Cardiology, Faculty of Medicine, Tanta University, Tanta, Egypt.