Impact of diabetes on 10-year outcomes of patients with multivessel coronary artery disease in the Medicine, Angioplasty, or Surgery Study II (MASS II) trial

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art_LIMA_Impact_of_diabetes_on_10_year_outcomes_of_2013.PDF (450.21 KB)
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52
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article
Data de publicação
2013
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Scopus
Web of Science
PubMed
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MOSBY-ELSEVIER
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AMERICAN HEART JOURNAL, v.166, n.2, p.250-257, 2013
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Unidades Organizacionais
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Resumo
Introduction Diabetes mellitus is a major cause of coronary artery disease (CAD). Despite improvement in the management of patients with stable CAD, diabetes remains a major cause of increased morbidity and mortality. There is no conclusive evidence that either modality is better than medical therapy alone for the treatment of stable multivessel CAD in patients with diabetes in a very long-term follow-up. Our aim was to compare 3 therapeutic strategies for stable multivessel CAD in a diabetic population and non-diabetic population. Methods It was compared medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) in 232 diabetic patients and 379 nondiabetic patients with multivessel CAD. Endpoints evaluated were overall and cardiac mortality. Results Patients (n = 611) were randomized to CABG (n = 203), PCI (n = 205), or MT (n = 203). In a 10-year follow-up, more deaths occurred among patients with diabetes than among patients without diabetes (P = .001) for overall mortality. In this follow-up, 10-year mortality rates were 32.3% and 23.2% for diabetics and non-diabetics respectively (P = .024). Regarding cardiac mortality, 10-year cardiac mortality rates were 19.4% and 12.7% respectively (P = .031). Considering only diabetic patients and stratifying this population by treatment option, we found mortality rates of 31.3% for PCI, 27.5% for CABG and 37.5% for MT (P = .015 for CABG vs MT) and cardiac mortality rates of 18.8%, 12.5% and 26.1% respectively (P = .005 for CABG vs MT). Conclusions/interpretation Among patients with stable multivessel CAD and preserved left ventricular ejection fraction, the 3 therapeutic regimens had high rates of overall and cardiac-related deaths among diabetic compared with nondiabetic patients. Moreover, better outcomes were observed in diabetic patients undergoing CABG compared to MT in relation to overall and cardiac mortality in a 10-year follow-up.
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https://observatorio.fm.usp.br/handle/OPI/3968
Referências
  1. [Anonymous], 2011, DIABETES CARE S, V34, pS62
  2. Banning AP, 2010, J AM COLL CARDIOL, V55, P1067, DOI 10.1016/j.jacc.2009.09.057
  3. Benedetto U, 2009, EUR J CARDIO-THORAC, V36, P611, DOI 10.1016/j.ejcts.2009.03.012
  4. Dangas GD, 2011, CIRCULATION, V123, P1745, DOI 10.1161/CIRCULATIONAHA.110.981688
  5. Elezi S, 1998, J AM COLL CARDIOL, V32, P1866, DOI 10.1016/S0735-1097(98)00467-7
  6. Farkouh ME, 2012, NEW ENGL J MED, V367, P2375, DOI 10.1056/NEJMoa1211585
  7. Friedrich K, 2012, J TOXICOL ENV HEAL A, V75, P63, DOI 10.1080/15287394.2012.624826
  8. Frye RL, 2009, NEW ENGL J MED, V360, P2503
  9. Hlatky MA, 2011, J THORAC CARDIOV SUR, V142, P829, DOI 10.1016/j.jtcvs.2010.09.063
  10. Hlatky MA, 2009, LANCET, V373, P1190, DOI 10.1016/S0140-6736(09)60552-3
  11. Hong YJ, 2009, JACC-CARDIOVASC IMAG, V2, P339, DOI 10.1016/j.jcmg.2008.10.017
  12. Hueb W, 2004, J AM COLL CARDIOL, V43, P1743, DOI 10.1016/j.jacc.2003.08.065
  13. Hueb W, 2007, ANN THORAC SURG, V83, P93, DOI 10.1016/j.athoracsur.2006.08.050
  14. Hueb W, 2010, CIRCULATION, V122, P949, DOI 10.1161/CIRCULATIONAHA.109.911669
  15. Ibebuogu UN, 2009, INT J CARDIOVAS IMAG, V25, P717, DOI 10.1007/s10554-009-9483-9
  16. Kapur A, 2010, J AM COLL CARDIOL, V55, P432, DOI 10.1016/j.jacc.2009.10.014
  17. Kwon Yong-Seop, 2010, Korean Circ J, V40, P581, DOI 10.4070/kcj.2010.40.11.581
  18. Lindsey JB, 2009, CIRC-CARDIOVASC INTE, V2, P543, DOI 10.1161/CIRCINTERVENTIONS.109.876672
  19. Moshkovitz Y, 2012, ANN THORAC SURG, V94, P1455, DOI 10.1016/j.athoracsur.2012.05.026
  20. Myers WO, 1999, J AM COLL CARDIOL, V33, P488, DOI 10.1016/S0735-1097(98)00563-4
  21. O'Keefe JH, 1998, EUR HEART J, V19, P1696, DOI 10.1053/euhj.1998.1153
  22. Onuma Y, 2011, JACC-CARDIOVASC INTE, V4, P317, DOI 10.1016/j.jcin.2010.12.004
  23. Pundziute G, 2007, DIABETES CARE, V30, P1113, DOI 10.2337/dc06-2104
  24. Rozenman Y, 1997, J AM COLL CARDIOL, V30, P1420, DOI 10.1016/S0735-1097(97)00342-2
  25. Serruys PW, 2009, NEW ENGL J MED, V360, P961, DOI 10.1056/NEJMoa0804626
  26. Soares PR, 2006, CIRCULATION, V114, pI420
  27. VLIETSTRA RE, 1982, ARTERIOSCLEROSIS, V2, P208

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - LIM/13
Artigos e Materiais de Revistas Científicas - ODS/03