Comparison of BARE metal stents versus drug eluting stents in patients with multivessel disease and diabetes. Results from a cardia trial substudy
- A Kapur, RJ Hall, AC Qureshi, IS Malik
- Heart 2009;95:A1–
Diabetes is challenging for revascularization due to specific disease related high risk clinical and angiographic features. In the early 90’s CABG was the preferred modality of revascularization in diabetics with multivessel disease due to high rate restenosis rates with percutaneous angioplasty alone (POBA) and bare metal stents (BMS). With advent of drug eluting stents (DES) the role of PCI in mutivessel disease in diabetics is gaining more acceptance. However, the issues of late stent thrombosis and need for lifelong anti-platelet therapy need to be addressed. Due to social factors especially in our country and evidence based data, we feel, diabetic patients with TVD should surely be offered CABG. Patients with two vessel disease and diabetes need to the treated depending on type of lesions (A, B or C). Most diabetic patients with single vessel disease where PCI is feasible and lesions can be covered with DIABETES & CORONARY ARTERY DISEASE; PCI OR CABG: PROS & CONS Gurpreet singh Wander, shibba takkar chhabra, Ludhiana single stent, PCI with DES can be offered. The result of ongoing randomized control trial (FREEDOM) may clarify the role of PCI with drug eluting stent and GP IIb/IIIa inhibitor versus CABG in diabetics who require multi vessel revascularization.