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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

Full text:  

 

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.

References

  1. Ageeva L.I., Aleksandrova G.A., Zaychenko N.M. et al. Healthcare in Russia. 2019. Moscow; 2019. http: //www.gks.ru (in Russ.).
  2. Ageeva L.I., Aleksandrova G.A., Zaychenko N.M. et al. Healthcare in Russia. 2019. Moscow; 2019. http: //www.gks.ru (in Russ.).
  3. Fox C.S. Cardiovascular disease risk factors, type 2 diabetes mellitus, and the Framingham Heart Study. Trends Cardiovasc. Med. 2010; 20 (3): 90–5. DOI: 10.1016/j.tcm.2010.08.001
  4. Shahim B., De Bacquer D., De Backer G., Gyberg V., Kotseva K., Mellbin L. et al. The prognostic value of fasting plasma glucose, two-hour postload glucose, and HbA1c in patients with coronary artery disease: a report from EUROASPIRE IV: a survey from the European Society of Cardiology. Diabetes Care. 2017; 40: 1233–40. DOI: 10.2337/dc17-0245
  5. Gnatiuc L., Herrington W., Halsey J.,Tuomilehto J., Fang X., Kim H. et al. Prospective Studies Collaboration and Asia Pacific Cohort Studies Collaboration. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol. 2018; 6: 538–46. DOI: 10.1016/s2213- 8587(18)30079-2
  6. Ritsinger V., Hero C., Svensson A.M., Saleh N., Lagerqvist B., Eeg-Olofsson K. et al. Characteristics and prognosis in women and men with type 1 diabetes undergoing coronary angiography: a nationwide registry report. Diabetes Care. 2018; 41: 878–83. DOI: 10.2337/dc17-2352
  7. Ledru F., Ducimetiere P., Battaglia S., Courbon D., Beverelli F., Guize L. et al. New diagnostic criteria for diabetes and coronary artery disease: insights from an angiographic study. J. Am. Coll. Cardiol. 2001; 37: 1543–50. DOI: 10.1016/s0735-1097(01)01183-4
  8. Golukhova E.Z., Kuznetsova E.V. Myocardial revascularization in patients with type 2 diabetes mellitus: An overview of modern techniques. Diabetes Mellitus. 2016; 19 (5): 406–13 (in Russ.). DOI: 10.14341/DM8031
  9. Aronson D., Edelman E.R. Revascularization for coronary artery disease in diabetes mellitus: angioplasty, stents and coronary artery bypass grafting. Rev. Endocr. Metab. Disord. 2010; 11 (1): 75–86. DOI: 10.1007/s11154-010-9135-3
  10. Luthra S., Leiva-Juarez M.M., Taggart D.P. Systematic Review of Therapies for Stable Coronary Artery Disease in Diabetic Patients. Ann. Thorac. Surg. 2015; 100 (6): 2383–97. DOI: 10.1016/j.athoracsur.2015.07.005
  11. Bockeria L.A., Glyantsev S.P. Professor Vasily Ivanovich Kolesov: parade of priorites (To the 50th anniversary of the world's first operation of mammary-coronary artery anastomosis and the 110th anniversary of the birth of its author – V.I. Kolesov). Russian Annals of Surgery. 2014; 3: 53–62 (in Russ.).
  12. Yusuf S., Zucker D., Peduzzi P., Fisher L.D., Takaro T., Kennedy J.W. et al. Effect of coronary artery bypass graft surgery on survival: Overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994; 344: 563–70. DOI: 10.1016/s0140-6736(94)91963-1
  13. Windecker S., Stortecky S., Stefanini G.G., da Costa B.R., Rutjes A.W., Di Nisio M. et al. Revascularisation versus medical treatment in patients with stable coronary artery disease: Network meta-analysis. BMJ. 2014; 348: g3859. DOI: 10.1136/bmj.g3859
  14. Fudulu D., Benedetto U., Pecchinenda G.G., Chivasso P., Bruno V.D., Rapetto F. et al. Current outcomes of off-pump versus on-pump coronary artery bypass grafting: evidence from randomized controlled trials. J. Thorac. Dis. 2016; 8 (10): 758–71. DOI: 10.21037/jtd.2016.10.80
  15. Greason K.L., Sundt T.M., III. Myocardial revascularization without cardiopulmonary bypass. In: Cohn L.H. (Ed.). Cardiac surgery in the adult. 4th ed. New York: The McGraw-Hill Companies; 2012: 505–22.
  16. Kowalewski M., Pawliszak W., Malvindi P.G., Bokszanski M.P., Perlinski D., Raffa G.M. et al. Off-pump coronary artery bypass grafting improves short-term outcomes in high-risk patients compared with on-pump coronary artery bypass grafting: Meta-analysis. J. Thorac. Cardiovasc. Surg. 2016; 151 (1): 60–77. DOI: 10.1016/j.jtcvs.2015.08.042
  17. Deppe A.C., Arbash W., Kuhn E.W., Slottosch I., Scherner M., Liakopoulos O.J. et al. Current evidence of coronary artery bypass grafting off-pump versus on-pump: a systematic review with metaanalysis of over 16,900 patients investigated in randomized controlled trials. Eur. J. Cardiothorac. Surg. 2016; 49 (4): 1031–41. DOI: 10.1093/ejcts/ezv268
  18. Lamy A., Devereaux P.J., Prabhakaran D., Taggart D.P., Hu S., Straka Z. et al. Five-year outcomes after off-pump or on-artery bypass grafting. N. Engl. J. Med. 2016; 375 (24): 2359–68. DOI: 10.1056/NEJMoa1601564
  19. Kip K., Faxon D.P., Detre K.M., Yeh W., Kelsey S.F., Currier J.W. et al. Coronary angioplasty in diabetic patients. The National heart, lung, and blood institute percutaneous transluminal coronary angioplasty registry. Circulation. 1996; 94: 1818–25. DOI: 10.1161/01.CIR.94.8.1818
  20. Brophy J.M., Belisle P., Joseph L. Evidence for use of coronary stents. A hierarchical bayesian metaanalysis. Ann. Intern. Med. 2003; 138: 7777–86. DOI: 10.7326/0003-4819-138-10-200305200-00005
  21. Carroza J., Kuntz R., Levine M., Levine M., Pomerantz R., Fishman R. et al. Angiographic and clinical outcome of intracoronary stenting: Immediate and long-term results from a large single-center experience. J. Am. Coll. Cardiol. 1992; 20: 328–37. DOI: 10.1016/0735-1097(92)90098-8
  22. Chieffo A., Aranzulla T.C., Colombo A. Drug eluting stents: focus on Cypher sirolimus-eluting coronary stents in the treatment of patients with bifurcation lesions. Vase Health Risk Manag. 2007; 3 (4): 441–51.
  23. Saeed B., Kandzari D.E., Agostoni P., Lombardi W.L., Rangan B.V., Banerjee S. et al. Use of drug-eluting stents for chronic total occlusions: a systematic review and meta-analysis. Catheter. Cardiovasc. Interv. 2011; 77: 315–32. DOI: 10.1002/ccd.22690
  24. Hermiller J.B., Raizner A., Cannon L., Gurbel P.A., Kutcher M.A., Wong S.C. et al. Outcomes with the polymer-based paclitaxel-eluting TAXUS stent in patients with diabetes mellitus: the TAXUS-IV trial. J. Am. Coll. Cardiol. 2005; 45 (8): 1172–9. DOI: 10.1016/j.jacc.2004.10.075
  25. Moussa I., León M.B., Baim D.S., O'Neill W., Popma J.J., Buchbinder M. et al. Impact of sirolimus-eluting stents on outcome in diabetic patients: a SIRIUS (SIRolImUS-coated Bx Velocity balloon-expandable stent in the treatment of patients with de novo coronary artery lesions) substudy. Circulation. 2004; 109 (19): 2273–8. DOI: 10.1161/01.CIR.0000129767.45513.71
  26. Virmani R., Guagliumi G., Farb A., Musumeci G., Grieco N., Motta T. et al. Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation. 2004; 109 (6): 701–5. DOI: 10.1161/01.CIR.0000116202.41966.D4
  27. Kibel A., Selthofer-Relatic K., Drenjancevic I., Bacun T., Bosnjak I., Kibel D. et al. Coronary microvascular dysfunction in diabetes mellitus. J. Int. Med. Res. 2017; 45 (6): 1901–29. DOI: 10.1177/0300060516675504
  28. Whitbeck M.G., Applegate R.J. Second generation drug-eluting stents: a review of the everolimuseluting platform. Clin. Med. Insights Cardiol. 2013; 7: 115–26. DOI: 10.4137/CMC.S11516
  29. Stone G.W., Rizvi A., Newman W., Mastali K., Wang J.C., Caputo R. et al. SPIRIT IV Investigators. Everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease. N. Engl. J. Med. 2010; 362: 1663–74. DOI: 10.1056/NEJMoa 0910496
  30. Bavishi C., Baber U., Panwar S., Pirrotta S., Dangas G.D., Moreno P. et al. Efficacy and safety of everolimus and zotarolimus-eluting stents versus first-generation drug-eluting stents in patients with diabetes: a meta-analysis of randomized trials. Int. J. Cardiol. 2017; 230: 310–8. DOI: 10.1016/j.ijcard.2016.12.116
  31. Wiebe J., Nef H.M., Hamm C.W. Current status of bioresorbable scaffolds in the treatment of coronary artery disease. J. Am. Coll. Cardiol. 2014; 64: 2541–51. DOI: 10.1016/j.jacc.2014.09.041
  32. Hommels T.M., Hermanides R.S., Rasoul S., Berta B., IJsselmuiden A.J.J., Jessurun G.A.J. et al. The 1-year safety and efficacy outcomes of Absorb bioresorbable vascular scaffolds for coronary artery disease treatment in diabetes mellitus patients: the ABSORB DM Benelux study. Neth. Heart J. 2019; 27 (11): 541–9. DOI: 10.1007/s12471-019-1293-7
  33. Schwartz L., Bertolet M., Feit F., Fuentes F., Sako E.Y., Toosi M.S. et al. Impact of completeness of revascularization on long-term cardiovascular outcomes in patients with type 2 diabetes mellitus: results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D). Circ. Cardiovasc. Interv. 2012; 5: 166–73. DOI: 10.1161/CIRCINTERVENTIONS.111.963512
  34. Sedlis S.P., Hartigan P.M., Teo K.K., Maron D.J., Spertus J.A., Mancini G.B. et al. Effect of PCI on long-term survival in patients with stable ischemic heart disease. N. Engl. J. Med. 2015; 373 (20): 1937–46. DOI: 10.1056/NEJMoa1505532
  35. Maron D.J., Hochman J.S., Reynolds H.R., Bangalore S., O'Brien S.M., Boden W.E. et al. ISCHEMIA research group. Initial invasive or conservative strategy for stable coronary disease. N. Engl. J. Med. 2020; 382 (15): 1395–407. DOI: 10.1056/NEJMoa1915922
  36. Kapur A., Hall R.J., Malik I.S., Qureshi A.C., Butts J., de Belder M. et al. Randomized comparison of percutaneous coronary intervention with coronary artery bypass grafting in diabetic patients. 1-year results of the CARDia (Coronary Artery Revascularization in Diabetes) trial. J. Am. Coll. Cardiol. 2010; 55: 432–40. DOI: 10.1016/j.jacc. 2009.10.014
  37. Kappetein A.P., Head S.J., Morice M.C., Banning A.P., Serruys P.W., Mohr F.W. et al. SYNTAX Investigators. Treatment of complex coronary artery disease in patients with diabetes: 5-year results comparing outcomes of bypass surgery and percutaneous coronary intervention in the SYNTAX trial. Eur. J. Cardiothorac. Surg. 2013; 43: 1006–13. DOI: 10.1093/ejcts/ezt017
  38. Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. Lancet. 2019; 394 (10206): 1325–34. DOI: 10.1016/S0140- 6736(19)31997-X
  39. Farkouh M.E., Domanski M., Sleeper L.A., Siami F.S., Dangas G., Mack M. et al. FREEDOM Trial Investigators. Strategies for multivessel revascularization in patients with diabetes. N. Engl. J. Med. 2012; 367: 2375–84. DOI: 10.1056/NEJMoa 1211585
  40. Park S.J., Ahn J.M., Kim Y.H., Park D.W., Yun S.C., Lee J.Y. et al. BEST Trial Investigators. Trial of everolimus-eluting stents or bypass surgery for coronary disease. N. Engl. J. Med. 2015; 372: 1204–12. DOI: 10.1056/NEJMoa1415447
  41. Stone G.W., Kappetein A.P., Sabik J.F., Pocock S.J., Morice M.C., Puskas J., Kandzari D.E. et al. Five-year outcomes after PCI or CABG for left main coronary disease. N. Engl. J. Med. 2019; 381 (19): 1820–30. DOI: 10.1056/NEJMoa1909406
  42. Head S.J., Milojevic M., Daemen J., Ahn J.M., Boersma E., Christiansen E.H. et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet. 2018; 391: 939–48. DOI: 10.1016/S0140-6736(18)30423-9
  43. Neumann F.J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U. et al. ESC scientific document group, 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019; 40 (2): 87–165. DOI: 10.1093/eurheartj/ehy394
  44. Kozlovskaya I.L., Lopukhova V.V., Bulkina O.S., Karpov Yu.A. The new european guidelines on myocardial revascularization: PCI in patients with stable CAD. Doctor.Ru. 2019; 2 (157): 6–11 (in Russ.) DOI: 10.31550/1727-2378-2019-157- 2-6-11

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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