Coronary disease & ACSSecondary analysis
Everolimus-Eluting Stents or Bypass Surgery for Multivessel Disease in Diabetics
- Secondary analysis of the BEST randomised trial
- subgroup analysis by diabetes status
- extended follow-up
Authors' conclusion
In diabetics with MVD, CABG was associated with better clinical outcomes than PCI. However, the mortality rate was similar between PCI and CABG irrespective of diabetes status during an extended follow-up.
Study context
- Population
- Patients with multivessel CAD, stratified by diabetes status363 diabetics · 517 nondiabetics
- Participants
- 880 patients
- Comparison
- Percutaneous coronary intervention (PCI) with everolimus-eluting stent vs coronary artery bypass grafting (CABG), by diabetes status
- Primary endpoint
- Composite of:
- Death
- MI
- Target vessel revascularization
- Follow-up
- Median 11.8 years (IQR: 10.6-12.5 years)
Primary result
As reported in the abstract
PCI vs CABGHazard ratio (95% CI)P value
diabetics: 43% vs 32%
1.53(1.12–2.08)
P = 0.008nondiabetics: 29% vs 29%
0.97(0.67–1.39)
P = 0.86Further findings
Any repeat revascularization
- Significantly higher with PCI than CABG
Safety
Safety composite (death, MI or stroke) and mortality
- No significant between-group differences, irrespective of diabetes
Original publication
Everolimus-Eluting Stents or Bypass Surgery for Multivessel Disease in Diabetics. JACC Cardiovasc Interv. Published 9 October 2023. doi:10.1016/j.jcin.2023.07.028
Summarised from the published abstract; every number is checked against it