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In diabetics, revascularization more likely after PCI vs CABG

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – For patients with diabetes and complex multivessel coronary artery disease, the risk of repeat vascularization within one year is elevated 3-fold after percutaneous coronary intervention (PCI) compared with surgery, according to a subgroup analysis from the multinational SYNTAX study.

Otherwise, rates of serious outcomes at 12 months in diabetic patients were similar after coronary artery bypass grafting (CABG) and PCI with the Taxus Express paclitaxel-eluting stents.

The SYNTAX study was the first to compare CABG and PCI with Taxus for complex left main and/or 3-vessel disease in both diabetic and nondiabetic patients, Dr. Adrian P. Banning and co-authors note in the Journal of the American College of Cardiology for March 16.

The trial evaluated major adverse cardiac and cerebrovascular events in 1800 patients, with a piori stratification based on the presence or absence of medically treated diabetes and left main disease The CABG group consisted of 897 subjects overall (676 nondiabetics, 221 with diabetes), and the PCI group contained 903 subjects (672 nondiabetics, 231 with diabetes). Only patients taking oral antiglycemics or insulin were classified as diabetics; patients controlling the disease by diet only were included in the nondiabetic group.

The primary SYNTAX endpoint