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  • Nystrom, T.Karolinska Institutet (författare)

PCI Versus CABG in Patients With Type 1 Diabetes and Multivessel Disease

  • Artikel/kapitelEngelska2017

Förlag, utgivningsår, omfång ...

  • Elsevier BV,2017

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/257746
  • https://gup.ub.gu.se/publication/257746URI
  • https://doi.org/10.1016/j.jacc.2017.07.744DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-334758URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:136591961URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND It is unknown if coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) may offer a survival benefit in patients with type 1 diabetes (T1D) in need of multivessel revascularization. OBJECTIVES This study sought to determine if patients with T1D and multivessel disease may benefit from CABG compared with PCI. METHODS In an observational cohort study, the authors included all patients with T1D who underwent a first multivessel revascularization in Sweden from 1995 to 2013. The authors used the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies) register, the Swedish National Diabetes Register, and the Swedish National Patient Register to retrieve information about patient characteristics and outcomes. They estimated hazard ratios (HRs) adjusted for confounders with 95% confidence intervals (CIs) for all-cause and coronary heart disease mortality, myocardial infarction, repeat revascularization, stroke, and heart failure using inverse probability of treatment weighting based on propensity scores. RESULTS In total, 683 patients whounderwent CABGand 1,863 patientswho underwent PCI were included. During a mean follow-up of 10.6 years, 53% of patients in the CABG group and 45% in the PCI group died. PCI, compared with CABG, was associated with a similar risk of all-cause mortality (HR: 1.14; 95% CI: 0.99 to 1.32), but higher risks of death from coronary heart disease (HR: 1.45; 95% CI: 1.21 to 1.74), myocardial infarction (HR: 1.47; 95% CI: 1.23 to 1.78), and repeat revascularization (HR: 5.64; 95% CI: 4.67 to 6.82). No differences in risks of stroke or heart failure were found. CONCLUSIONS Notwithstanding the inclusion of patients with T1D who might not have been able to undergo CABG in the PCI group we found that PCI, compared with CABG, was associated with higher rates and risks of coronary heart disease mortality, myocardial infarction, and repeat revascularizations. Our findings indicate that CABG may be the preferred strategy in patients with T1D in need of multivessel revascularization. (J Am Coll Cardiol 2017; 70: 1441-51) (C) 2017 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Sartipy, U.Karolinska Institutet (författare)
  • Franzén, Stefan,1967Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Sahlgrens Univ Hosp, Ctr Registers Reg Vastra Gotaland, Inst Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden.(Swepub:gu)xfrast (författare)
  • Eliasson, Björn,1959Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Sahlgrens Univ Hosp, Ctr Registers Reg Vastra Gotaland, Inst Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden.(Swepub:gu)xelibj (författare)
  • Gudbjörnsdottir, Soffia,1962Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Sahlgrens Univ Hosp, Ctr Registers Reg Vastra Gotaland, Inst Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden.(Swepub:gu)xgudso (författare)
  • Miftaraj, M.Karolinska Institutet (författare)
  • Lagerqvist, Bo,1952-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)bolager (författare)
  • Svensson, A. M.Sahlgrens Univ Hosp, Ctr Registers Reg Vastra Gotaland, Inst Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden. (författare)
  • Holzmann, M. J.Karolinska Univ Hosp, Funct Area Emergency Med, C1 63, S-14186 Stockholm, Sweden.;Karolinska Inst, Dept Internal Med, Stockholm, Sweden. (författare)
  • Karolinska InstitutetInstitutionen för medicin (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Journal of the American College of Cardiology: Elsevier BV70:12, s. 1441-14510735-10971558-3597

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