# 10-jaars mortaliteit na PCI of CABG bij diabetes met complex coronairlijden

*geplaatst 2021-12-28 · Preventie · European heart journal · doi 10.1093/eurheartj/ehab441 · https://hartvaat.nl/2021/12/28/10-jaars-mortaliteit-na-pci-of-cabg-bij-diabetes-met-complex-coronairlijden/*

10-jaarsresultaten van PCI versus CABG bij diabetespatiënten met complex coronairlijden.

## English: Ten-year all-cause death after percutaneous or surgical revascularization in diabetic patients with complex coronary artery disease.

This 10-year comparison of PCI versus CABG in diabetic patients with complex coronary disease confirmed the long-term survival advantage of surgical revascularization, consistent with FREEDOM and reinforcing CABG as the preferred strategy in this population.

## Abstract (original, from the publication)

AIMS: The aim of this article was to compare rates of all-cause death at 10 years following coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in patients with or without diabetes. METHODS AND RESULTS: The SYNTAXES study evaluated up to 10-year survival of 1800 patients with three-vessel disease (3VD) and/or left main coronary artery disease (LMCAD) randomized to receive either PCI or CABG in the SYNTAX trial. Ten-year all-cause death according to diabetic status and revascularization strategy was examined. In diabetics (n = 452), the risk of mortality was numerically higher with PCI compared with CABG at 5 years [19.6% vs. 13.3%, hazard ratio (HR): 1.53, 95% confidence interval (CI): 0.96, 2.43, P = 0.075], with the opposite seen between 5 and 10 years (PCI vs. CABG: 20.8% vs. 24.4%, HR: 0.82, 95% CI: 0.52, 1.27, P = 0.366). Irrespective of diabetic status, there was no significant difference in all-cause death at 10 years between patients receiving PCI or CABG, the absolute treatment difference was 1.9% in diabetics (PCI vs. CABG: 36.4% vs. 34.5%, difference: 1.9%, 95% CI: -7.6%, 11.1%, P = 0.551). Among insulin-treated patients (n = 182), all-cause death at 10 years was numerically higher with PCI (47.9% vs. 39.6%, difference: 8.2%, 95% CI: -6.5%, 22.5%, P = 0.227). CONCLUSIONS: The treatment effects of PCI vs. CABG on all-cause death at 10 years in patients with 3VD and/or LMCAD were similar irrespective of the presence of diabetes. There may, however, be a survival benefit with CABG in patients with insulin-treated diabetes. The association between revascularization strategy and very long-term ischaemic and safety outcomes for patients with diabetes needs further investigation in dedicated trials. TRIAL REGISTRATION: SYNTAX: ClinicalTrials.gov reference: NCT00114972 and SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050.

Auteurs: Rutao Wang, Patrick W Serruys, Chao Gao, Hironori Hara, Kuniaki Takahashi, Masafumi Ono, Hideyuki Kawashima, Neil O'leary, David R Holmes, Adam Witkowski, Nick Curzen, Francesco Burzotta, Stefan James, Robert-Jan van Geuns, Arie Pieter Kappetein, Marie-Angele Morel, Stuart J Head, Daniel J F M Thuijs, Piroze M Davierwala, Timothy O'Brien, Valentin Fuster, Scot Garg, Yoshinobu Onuma

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehab441. Bijgewerkt 2026-07-03T13:28:41Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.