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The choice of revascularization method in patients with stable coronary artery disease and diabetes mellitus

Authors: Kudryashova E.N., Berdibekov B.Sh., Bulaeva N.I., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2021-15-1-61-71

For citation: Kudryashova E.N., Berdibekov B.Sh., Bulaeva N.I., Golukhova E.Z. The choice of revascularization method in patients with stable coronary artery disease and diabetes mellitus. Creative Cardiology. 2021; 15 (1): 61–71 (in Russ.). DOI: 10.24022/1997-3187-2021-15-1-61-71

Received / Accepted:  10.03.2021 / 18.03.2021

Keywords: diabetes mellitus myocardial revascularization coronary artery bypass grafting percutaneous coronary intervention

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Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains the major cause of death and disability, especially among patients with type 2 diabetes mellitus (T2DM). Patients with T2DM have an earlier manifestation of coronary artery disease (CAD), worse prognosis and excess risks of death from any cause and of ASCVD mortality. This is due to the diffuse multivessel disease, with distal lesions as well as the most frequent injury of the left main coronary artery (LMCA). The choice of optimal revascularization strategy is very important for the improving clinical results and long-term outcomes in this group of patients. According to the latest results of randomized clinical trials, coronary artery bypass grafting (CABG) is more preferable for patients with T2DM in most clinical situations. The exception is 1-, 2-vessel disease without proximal left anterior descending (LAD) disease when suggest benefits from percutaneous coronary intervention (PCI). Meanwhile, a risk-adjusted comparison of revascularization strategies (CABG or PCI), including 1-, 2-vessel disease with involvement of the proximal LAD, as well as left main lesion with low SYNTAX Score (<22), did not find any significant differences between both methods.

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About Authors

  • Elena N. Kudryashova, Postgraduate, ORCID
  • Bektur Sh. Berdibekov, Postgraduate, ORCID
  • Naida I. Bulaeva, Cand. Biol. Sc., Senior Researcher, Cardiologist, SPIN: 8979-7098, ORCID
  • Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of RAS, Director, SPIN: 9334-5672, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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