Discussion on the revascularization strategies in patients with chronic total occlusion of coronary artery and diabetes mellitus
Feng Tingting
Yan Yunfeng
Yang Lirui
Zhao Lin
Abstract：Objective To investigate the clinical outcomes of different revascularization strategies in patients with chronic total occlusion(CTO)and diabetes mellitus.Methods Patients with CTO and diabetes mellitus hospitalized in Beijing Anzhen Hospital,Capital Medical University from January 1,2007 to December 31,2017 were enrolled in this study.The patients were divided into CTO-S-percutaneous coronary intervention(PCI)group(successful CTO-PCI patients)and CTO-S-coronary artery bypass grafting(CABG)group(successful CTO-CABG patients)according to the different revascularization strategies.The primary endpoint was a composite endpoint of major adverse cardiovascular events(MACE).Other outcome measures included death from any cause and reperfusion.The clinical outcomes were compared between the two groups.Results A total of 1 062 patients were included in this study,including 683 in the CTO-S-PCI group and 379 in the CTO-S-CABG group.In terms of MACE,the CTO-S-CABG group was better than the CTO-S-PCI group[6.1％(23/379)vs 20.8％(142/683)](P＜0.05).This advantage was consistent with target-vessel reperfusion,recurrent nonfatal myocardial infarction,and reperfusion.However,there was no significant difference in cardiac death and all-cause death between the two groups(all P＞0.05).Conclusion For patients with CTO and diabetes mellitus,CABG is superior to PCI and can reduce the incidence of MACE.
Keywords：Chronic total occlusionDiabetes mellitusPercutaneous coronary interventionCoronary artery bypass grafting
Publication Date：2024-02-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 166-170 )