Akut koroner sendromlu diyabetik hastalarda aort-koroner bypass cerrahisi ile yeni nesil ilaç salınımlı stentlerle uygulanan perkütan koroner girişimin erken ve uzun dönem sonuçlarının karşılaştırılması

Year 2020, Volume: 45 Issue: 4, 1302 - 1308, 27.12.2020

Firdovsi Ibrahimov , Latife Kayıkçıoğlu , Shafa Shahbazova , Isfendiyar Ismayilov Oktay Musayev , Kamran Musayev , Shahane Elesgerli

https://doi.org/10.17826/cumj.671845

Abstract

Amaç: Bu çalışmanın amacı diyabetik olgularda akut koroner sendrom (AKS) sırasında koroner arter baypas greft (KABG) ve Perkütan koroner girişim (PKG) (yeni nesil ilaç salınımlı stentlerle) uygulanmasının sonuçları arasındakifarkı belirlemekti.
Gereç ve Yöntem: Tek merkezde 2 yıllık dönemde AKS ile başvuran 405 diyabetik hastayı retrospektif olarak değerlendirdik. Hastalar 5 yıl boyunca takip edildi. Tüm nedenlerle ilişkili ölüm, kardiyak ölüm, miyokard enfarktüsü, inme, revaskülarizasyon ve stent trombozu gibi tüm klinik olaylar buna göre kaydedildi.
Bulgular: AKS'li 1643 hastanın 405'i diyabetli hastayı inceledik. Bunlardan 183'ü (% 45.1) PKG grubuna, 222'si (% 54.8) KABG grubuna dahil edildi. 5 yıllık takip sırasında, PKG grubunda 31 hastada (% 16.9) ve KABG grubunda 33 hastada (% 14.9) ölüm, MI ve inme gibi primer son noktalar gözlendi. İki grup arasında primer sonlanım noktaları arasında fark yoktu. 5 yıl boyunca tüm neden mortalite PKGI grubunda 17 hastada (% 9.8), KABG grubunda 20 hastada (% 9.1) gözlendi.
Sonuç: 5 yıllık takip sırasında PKG ve KABG grupları arasında tüm nedenlere bağlı mortalite açısından fark yoktu. Tekrarlanan revaskülarizasyon ve miyokard enfarktüsü, PKG grubunda KABG grubuna göre daha yüksekti. Buna karşılık inme oranları KABG grubunda daha yüksekti.

Keywords

PCI, CABG, Stent, acute coronary syndrome

Comparison of the early and long-term results of aortic-coronary bypass surgery and percutaneous coronary intervention with new generation drug-eluting stents in diabetic patients with acute coronary syndrome

Abstract

Purpose: The aim of this study was to determine the difference between patients undergoing coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) (with new generation drug-eluting stents) who had diabetes mellitus during the course of an acute coronary syndrome (ACS).
Materials and Methods: We carried out a retrospective evaluation of 405 diabetic patients admitted with an ACS during the period of 2 years in a single-center. Patients were followed for 5 years. All clinical incidents, such as death, cardiac death, myocardial infarction, stroke, revascularization, and stent thrombosis were recorded
Results: We examined 405 patients with diabetes out of 1643 patients with ACS. Of these, 183 (45.1%) were included in the PCI group and 222 (54.8%) were in the CABG group. During 5-years follow-up, primary endpoints including death, MI, and stroke were observed in 31 patients (16.9%) in the PCI group and in 33 patients (14.9%) in the CABG group. There was no difference between the two groups in terms of primary endpoints. All-cause mortality during 5-years was observed in 17 patients (9.8%) in the PCI, 20 (9.1%) in the CABG group.
Conclusion: There was no difference in all-cause mortality between the PCI and the CABG groups during 5-year follow-up. Repeated revascularization and myocardial infarction were higher in the PCI group and the stroke rates were higher in the CABG group.

Keywords

acute coronary syndrome

References

• Referans1: Serruys PW, Morice MC, Kappetein AP et al. ; SYNTAX Investigators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009;360: 961–972.)
• Referans2:Farkouh ME, Domanski M, Sleeper LA, Siami FS, Dangas G, Mack M, Yang M, Cohen DJ, Rosenberg Y, Solomon SD, Desai AS, Gersh BJ, Magnuson EA, Lansky A, Boineau R, Weinberger J, Ramanathan K, Sousa JE, Rankin J, Bhargava B, Buse J, Hueb W, Smith CR, Muratov V, Bansilal S, King S III, Bertrand M, Fuster V; FREEDOM Trial Investigators. Strategies for multivessel revascularization in patients with diabetes. N Engl J Med 2012;367:2375–2384.)