Abstract 12078: Impact of Diabetes on Ten-Year Outcomes of Patients with Multivessel Coronary Artery Disease in the MASS II Trial
Background. Diabetes mellitus is a major cause of coronary artery disease. Despite improvement in the management of patients with stable coronary artery disease, diabetes remains a major cause of increased morbidity and mortality. There is no conclusive evidence that either treatment modality is better than medical therapy alone for the treatment of stable multivessel coronary disease in patients with diabetes in a long term follow-up.
Methods. We compared medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG ) in 232 diabetic patients and 379 non diabetic patients with multivessel coronary disease. End points considered were: overall and cardiac death.
Results: Patients (n=611) were randomized to CABG (n=203), PCI (n=205), or MT (n=203). In a 10-year follow-up, more deaths occurred among patients with diabetes than among non diabetes patients, regardless of which therapeutic option was used (p =0.014 for overall mortality and p =0.046 for cardiac death). Probability overall death free survival in diabetic population was 76.3% for CABG, 71.9% for PCI, and 62.5% for MT (p=0.014). Probability cardiac death free survival in this same population was 87.5% for CABG, 81.3% for PCI and 73.9% for MT (p=0.036).
Conclusions. All three therapeutic regimens resulted in high rates of overall and cardiac related death among patients with diabetes compared with non diabetes patients. Moreover, we observed better outcomes among patients with diabetes and multivessel coronary artery disease undergoing CABG regarding overall and cardiac mortality in a10-year follow-up.
- © 2011 by American Heart Association, Inc.