AUTHOR=Liang Bo , He Xin , Gu Ning 

TITLE=Reassessing Revascularization Strategies in Coronary Artery Disease and Type 2 Diabetes Mellitus

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.738620

DOI=10.3389/fcvm.2021.738620

ISSN=2297-055X

ABSTRACT=Percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is still controversial in patients with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM). Here, we aimed to evaluate the safety of PCI and CABG in those population. Relevant randomized controlled trials were retrieved from PubMed, Embase and the Cochrane databases. The pooled results were represented as risk ratios (RRs) with 95 % confidence intervals (CIs) with STATA software. A total of 6 trials with 1766 patients received CABG and 2262 patients received PCI were included in our study. Patients in CABG group was significantly associated with a lower all-cause mortality compared to these in PCI group (RR = 0.74, 95% CI = 0.56 ~ 0.98, P = 0.037). Cardiac mortality, recurrent myocardial infarction, and repeat revascularization were also significantly lower in the CABG group (RR = 0.79, 95% CI = 0.40 ~ 1.53, P = 0.479; RR = 0.70, 95% CI = 0.32 ~ 1.56, P = 0.387; and RR = 0.36, 95% CI = 0.28 ~ 0.46, P < 0.0001; respectively). However, compared to the PCI group, cerebralvascular accident was higher in the CABG group (RR = 2.18, 95% CI = 1.43 ~ 3.33, P < 0.0001). There was no publication bias in our study. CABG revascularization was associated with significantly lower long-term adverse clinical outcomes, except cerebralvascular accident, compared to PCI in patients with CAD and T2DM.