5-Year follow-up of coronary revascularization in diabetic patients with multivessel coronary artery disease: insights from ARTS (arterial revascularization therapy study)-II and ARTS-I trials.

We compared the 5-year outcomes of diabetic patients with multivessel disease treated with sirolimus-eluting stents (SES), bare-metal stents (BMS), and coronary artery bypass graft surgery (CABG) enrolled in the ARTS (Arterial Revascularization Therapy Study) I and II studies. Diabetes is an established risk factor for major adverse cardiac events after revascularization. Recent trials suggest that revascularization with drug-eluting stents has equivalent safety to CABG up to 2 years. The ARTS I and II studies included 367 diabetic patients (SES: 159, CABG: 96, and BMS: 112) compared with respect to 5-year clinical outcomes. The rate of major adverse cardiovascular and cerebrovascular events was significantly higher in patients treated with BMS (BMS 53.6% vs. CABG 23.4% vs. SES 40.5%; log-rank, p < 0.01 for SES vs. BMS and SES vs. CABG). There was no significant difference in mortality among all 3 groups. There was, however, a statistically significant difference in the myocardial infarction rate between BMS and CABG arms (BMS 11.0%, CABG 5.2%, SES 4.8%, p = 0.04 for SES vs. BMS and p = 0.76 for SES vs. CABG). The rate of repeat revascularization was significantly lower in patients treated with CABG compared with SES (SES 33.2% vs. CABG 10.7%, p < 0.001). Revascularization rate of patients treated with SES at 5 years approached that of patients treated with BMS although remained significantly lower. This "catch-up" phenomenon was not apparent in the nondiabetic population. At 5-year follow-up, CABG has comparable safety and superior efficacy compared with BMS and SES in the treatment of diabetic patients with multivessel disease.

Onuma Y ，Wykrzykowska JJ ，Garg S ，Vranckx P ，Serruys PW ，ARTS I and II Investigators ... -  《-》

Five-year outcomes of percutaneous coronary intervention compared to bypass surgery in patients with multivessel disease involving the proximal left anterior descending artery: an ARTS-II sub-study.

Garg S ，Sarno G ，Gutiérrez-Chico JL ，Garcia-Garcia HM ，Gomez-Lara J ，Serruys PW ，ARTS-II investigators ... -  《-》

Sirolimus-eluting stents, bare metal stents or coronary artery bypass grafting for patients with multivessel disease including involvement of the proximal left anterior descending artery: analysis of the Arterial Revascularization Therapies study part 2 (

Kukreja N ，Serruys PW ，De Bruyne B ，Colombo A ，Macaya C ，Richardt G ，Fajadet J ，Hamm C ，Goedhart D ，Macours N ，Stoll HP ，ARTS-II Investigators ... -  《-》

The Bypass Angioplasty Revascularization in Type 1 and Type 2 Diabetes Study: 5-year follow-up of revascularization with percutaneous coronary intervention versus coronary artery bypass grafting in diabetic patients with multivessel disease.

Kapur A ，Bartolini D ，Finlay MC ，Qureshi AC ，Flather M ，Strange JW ，Hall RJ ... -  《-》

Five-year clinical outcomes after coronary stenting of chronic total occlusion using sirolimus-eluting stents: insights from the rapamycin-eluting stent evaluated at Rotterdam Cardiology Hospital-(Research) Registry.

Shen ZJ ，García-García HM ，Garg S ，Onuma Y ，Schenkeveld L ，van Domburg RT ，Serruys PW ，Interventional Cardiologists at Thoraxcentre in 2000-2003 ... -  《-》