LONG-TERM OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION VS CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH DIABETES MELLITUS WITH MULTIVESSEL DISEASE: A META-ANALYSIS

SESSION TITLE: Cardiovascular Disease Posters 3 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Long term cardiovascular outcome comparison of multivessel coronary disease among patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is limited. To compare the long-term cardiovascular outcome PCI vs CABG among DM patients with multivessel disease. METHODS: Online databases were explored to identify studies that compared cardiovascular outcomes between PCI and CABG among patients with DM and multi-vessel coronary disease. The primary outcome was all-cause mortality. Secondary outcomes included major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction (MI), rate of revascularization, cardiac death, and cerebrovascular accident (CVA). RESULTS: A total of 27 studies with 37,091 (PCI n=19,838 (53%) and CABG n=17,253 (47%)) patients were included in our analysis. The mean age was 64 ± 5.9 years for PCI group and 63.8 ± 5.3 years for CABG group; and, predominantly male (71.22% vs 74.29%) for PCI and CABG respectively. The most common comorbidity was hypertension (64.35% vs 62.88%) in both PCI and CABG respectively. Compared with CABG, PCI group had a higher odds of overall all-cause mortality (OR 1.18, 95% CI 1.02-1.37, p=0.03), MACCE (OR 1.52, 95% CI 1.31-1.75, p=0.00), MI (OR 1.85, 95% CI 1.46-2.36, p=0.00), repeat revascularization (OR 3.08, 95% CI 2.34-4.05, p=0.00) and cardiac death (OR 1.27, 95% 1.02-1.59, p=0.04), while CVA (0.57, 95% CI 0.37-0.86, p=0.01) was higher in the CABG compared to PCI. CONCLUSIONS: Diabetic patients with multivessel coronary artery disease have worse outcomes undergoing PCI as compared to CABG. However, CVA was significantly higher with CABG. CLINICAL IMPLICATIONS: CABG remains the preferred management among eligible patients with DM and multivessel disease. DISCLOSURES: No relevant relationships by Ronny Antony No relevant relationships by Simrat Batth No relevant relationships by Michael Bogart No relevant relationships by Samkit Jain No relevant relationships by Andrew Kim No disclosure on file for Joseph Lieber No relevant relationships by Daniel Mozell No relevant relationships by Tanya Rastogi No relevant relationships by Vaibhav Shah No relevant relationships by Ranbir Singh No relevant relationships by David Song