Abstract 3241: Long-TermSurvival after Coronary Artery Bypass versus Percutaneous Coronary Intervention with Bare Metal Stent Implantation in Patients with Diabetic Retinopathy
Background: Coronary heart disease is the leading cause of death in diabetic population. Compared with diabetics without retinopathy, diabetics with retinopathy have an increased risk of myocardial infarction and death from coronary heart disease. Therefore, it is crucial to select an appropriate revascularization method in this considerable high-risk group.
Methods: Between 1996 and 2004, a total of 149 patients with diabetic retinopathy underwent revascularization, either coronary artery bypass surgery (CABG) (n=56) or percutaneous coronary intervention with bare metal stents (BMS) (n=94). We compared overall survival rates of the two methods. Mortality was estimated according to Kaplan-Meier methods and was compared using the log-rank test.
Results: The average follow-up from the time of the initial revascularization was 59.7 ± 33.3 months. During the entire follow-up, there was 8(14.5%)death in the CABG group and 27(28.7%) deaths in the BMS group. The average duration between death and revascularization was 81.3 ± 24.6 for the CABG group and 29.9 ± 23.8 for the BMS group (P<0.001). The 6-year overall survival was 94.8% for the CABG group and 73.6% for the BMS group. Mortality curves differed significantly between the two groups (P=0.004) (Figure⇓). After adjustment for baseline characteristics including age, sex, HbA1c, insulin, serum creatinine, ejection fraction, and the extent of coronary disease, the hazard ratio of death afforded by CABG was 0.36 (95% confidence interval, 0.15–0.87; P=0.023).
Conclusions: In patients with diabetic retinopathy, CABG conferred survival benefit over BMS implantation.