- Among patients with left main (LM) coronary artery disease (CAD) and low or intermediate CAD complexity, those with diabetes mellitus (DM) had similar 3-year outcomes after percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES) vs coronary artery bypass grafting (CABG).
- Results are hypothesis-generating.
- Editorial discusses how to choose revascularization technique in LMCAD patients.
Why this matters
- CABG is preferred revascularization technique for diabetic patients with complex CAD, but PCI and CABG techniques have recently improved.
- With DM vs without:
- Primary outcome: 20.0% vs 12.9% (P<.001>
- All-cause death: 10.9% vs 5.3% (P<.001>
- Diabetic patients: 20.7% vs 19.3% (P=.87).
- Nondiabetic patients: 12.9% vs 12.9% (P=.89).
- Prespecified subgroup analysis of EXCEL (N=1905).
- Patients with LMCAD and low or intermediate SYNTAX score randomly assigned to CABG vs PCI with second-generation EES.
- Authors analyzed outcome among patients with DM vs without (n=554 and 1350, respectively).
- Outcome: 3-year composite of all-cause death, stroke, myocardial infarction.
- Funding: Abbott Vascular.
- Underpowered to assess primary outcome with PCI vs CABG in subgroup with diabetes.