• Yan Qiao, Changsheng Ma, Shaoping Nie, Xiaohui Liu, Junping Kang, Qiang Lv, Xin Du, Rong Hu, Yin Zhang, Changqi Jia, Xinmin Liu, Jianzeng Dong, Fang Chen, Yujie Zhou, Shuzheng Lv, Fangjiong Huang, Chengxiong Gu, and Xuesi Wu.
• Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
• Clin Cardiol. 2009 Aug 1;32(8):E24-30.

BackgroundStudies comparing coronary artery bypass grafting (CABG) with drug-eluting stent (DES) for the treatment of diabetic patients with multivessel disease are relatively scarce although controversies exist concerning the relative efficacy of CABG versus DES.HypothesisThe aim of this study was to evaluate the effect of drug-eluting stent (DES) implantation in diabetic patients with multivessel disease compared with CABG.MethodsWe included 645 consecutive diabetic patients who underwent either CABG (n = 282) or DES implantation (n = 363) in our institution from July 2003 to December 2005.ResultsAt 12 mo after index revascularization procedure, the total mortality rate was similar in the CABG and DES group (3.2% versus 3.0%, hazard ratio [HR] of CABG versus percutaneous coronary intervention [PCI] 0.58, 95% confidence interval [CI]: 0.14 to 2.45, p = 0.460), but the rate of major adverse cardiac cerebrovascular events was lower in the CABG group (7.8% versus 17.9%, HR: 0.15, 95% CI: 0.06 to 0.37, p < 0.001) mainly due to less repeat revascularization with CABG (1.4% versus 11.6%, HR: 0.02, 95% CI: 0.01 to 0.13, p < 0.001). Age, 3-vessel disease, and serum creatinine > or =1.5 mg/dl were positive independent predictors of 12 mo death.ConclusionsAt 12 mo, CABG was associated with less adverse events primarily due to less repeat revascularization compared with DES although there was no significant difference in mortality and myocardial infarction (MI) rates between the 2 groups; high repeat revascularization rate related to DES resulted from high restenosis rate in diabetic patients and lower rate of complete revascularization offered by PCI.

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