Medical therapy
Publication/Presentation Date
11-26-2020
Abstract
BACKGROUND: Management of chronic total occlusions (CTO) in diabetics is challenging, with a recent trend towards early revascularization [ER: Percutaneous coronary intervention (PCI) and bypass grafting] instead of optimal medical therapy (OMT). We hypothesize that ER improves morbidity and mortality outcomes in diabetic patients with CTOs as compared to OMT.
AIM: To determine the long term clinical outcomes and to compare morbidity and mortality between OMT and ER in diabetic patients with CTOs.
METHODS: Potentially relevant published clinical trials were identified in Medline, Embase, chemical abstracts and Biosis (from start of the databases till date) and pooled hazard ratios (HR) computed using a random effects model, with significant
RESULTS: OMT was associated with a higher all-cause mortality [HR: 1.70, 95% confidence interval (CI): 0.80-3.26,
CONCLUSION: In diabetic patients with CTO, there was a trend for improved outcomes with ER regarding all-cause and cardiac death as compared to OMT. These findings were reinforced with statistical significance on subgroup analysis of OMT
Volume
12
Issue
11
First Page
559
Last Page
570
ISSN
1949-8462
Published In/Presented At
Khan, M. S., Sami, F., Singh, H., Ullah, W., Al-Dabbas, M., Changal, K. H., Mir, T., Ali, Z., & Kabour, A. (2020). Medical therapy vs early revascularization in diabetics with chronic total occlusions: A meta-analysis and systematic review. World journal of cardiology, 12(11), 559–570. https://doi.org/10.4330/wjc.v12.i11.559
Disciplines
Medicine and Health Sciences
PubMedID
33312441
Department(s)
Fellows and Residents
Document Type
Article