The Particulars: Data from studies comparing CABG to PCI has been inconsistent when assessing these procedures in patients with diabetes and multivessel coronary artery disease (CAD). Little is known about the effect of these procedures in the era of drug-eluting stents.
Data Breakdown: Canadian researchers reviewed data from eight trials comparing PCI and CABG in patients with diabetes and stable CAD. Mortality rates were similar at 1 year for both CABG and PCI. However, the mortality rate was lower for CABG patients at 5 years (relative risk, 0.67) when compared with PCI patients. Repeat revascularization rates were lower for CABG at 1 and 5 years than for PCI. However, rates of stroke were higher with CABG than with PCI at both 1 and 5 years. Overall results were similar among trials using bare-metal stents and drug-eluting stents.
Take Home Pearls: Among patients with diabetes and CAD, CABG appears to have about a 35% lower mortality rate and 60% lower rate of repeat revascularization when compared with PCI. However, the rate of stroke with CABG appears to be twice as high as the rate with PCI in diabetes with CAD.