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Long-term outcomes of myocardial revascularization performed by various methods in patients with type 2 diabetes mellitus

Authors: Kudryashova E.N., Berdibekov B.Sh., Bulaeva N.I., Merzlyakov V.Yu., Petrosyan K.V., Batov S.M., Salomov M.A., Dzhidzalova D.H., Khoroshikh L.V., Efendieva A.S., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18S-S82–S94

For citation: Kudryashova E.N., Berdibekov B.Sh., Bulaeva N.I., Merzlyakov V.Yu., Petrosyan K.V., Batov S.M., Salomov M.A., Dzhidzalova D.H., Khoroshikh L.V., Efendieva A.S., Golukhova E.Z. Long-term outcomes of myocardial revascularization performed by various methods in patients with type 2 diabetes mellitus. Creative Cardiology. 2024; 18 (Special Issue): S82–S94 (in Russ.). DOI: 10.24022/1997-3187-2024-18S-S82–S94

Received / Accepted:  15.11.2024 / 25.12.2024

Keywords: сoronary artery bypass grafting percutaneous coronary intervention diabetes mellitus

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Abstract

Objective. To study the long-term outcomes of myocardial revascularization performed using different techniques (coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)) in patients with type 2 diabetes mellitus.

Material and methods. The study included 80 patients who underwent CABG and 70 patients who underwent PCI. The average age of the patients was 61.8 ± 7.1 years, of which 110 (73.3%) were male. The median follow-up period was 7 (6–9) years. The primary composite endpoint was represented by major adverse cardiac and cerebrovascular events (MACCE): all-cause mortality, cardiac death, non-fatal myocardial infarction, and non-fatal stroke. The secondary endpoint included individual components of MACCE as well as the presence of repeat myocardial revascularization or indications for it during the long-term follow-up period.

Results. In the long-term period, there were no statistically significant differences between the CABG and PCI groups in the frequency of MACCE registration (15.8 and 14.1%, respectively; unadjusted hazard ratio (HR) 0.89; 95% сonfidence interval (CI) 0.38–2.13, p = 0.800), as well as its individual components, such as all-cause mortality (7.9 and 7.8% respectively, p = 1.00), cardiac death (2.6 and 1.6% respectively, p = 1.00), non-fatal myocardial infarction (6.6 and 3.1% respectively, p = 0.454), and non-fatal stroke (3.9 and 4.7% respectively, p = 1.00). However, the need for repeat revascularization was statistically significantly higher in the PCI group compared to the CABG group (48.4 and 15.8% respectively; adjusted HR 4.08; 95% CI 1.93–8.60, p ˂ 0.001).

Conclusion. Compared to PCI, CABG is associated with a significantly lower risk of the need for repeat myocardial revascularization, while no significant differences in mortality or cardiovascular events were found between the groups depending on the revascularization technique.

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About Authors

  • Elena N. Kudryashova, Cardiologist; ORCID
  • Bektur Sh. Berdibekov, Cand. Med., Sci., Junior Researcher, Cardiologist; ORCID
  • Naida I. Bulaeva, Cand. Biol. Sci., Associate Professor, Head of Department, Cardiologist; ORCID
  • Vadim Yu. Merzlyakov, Dr. Med. Sci., Professor, Head of Department; ORCID
  • Karen V. Petrosyan, Dr. Med. Sci., Professor, Head of Department; ORCID
  • Sergey M. Batov, Cardiovascular Surgeon; ORCID
  • Makhmadsharif A. Salomov, Junior Researcher, Cardiovascular Surgeon; ORCID
  • Diana H. Dzhidzalova, Cardiologist; ORCID
  • Ludmila V. Khoroshikh, Cardiologist; ORCID
  • Anastasiya S. Efendieva, Cardiologist; ORCID
  • Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of RAS, Director; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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