SPC365

CABG vs PCI for diabetic patients with non-ST elevation ACS: in-hospital outcomes

Session: Posters (Sessão 2 - Écran 6) - DAC e Cuidados Intensivos 3 - SCAsST
Speaker: Carolina Saleiro

Congress: CPC 2022
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 13. Acute Coronary Syndromes
Subtheme: 13.4 Acute Coronary Syndromes – Treatment
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Carolina Saleiro; Joana m Ribeiro; Diana de Campos; João Lopes; Ana r m Gomes; José p Sousa; Alexandrina Siserman; Carolina Lourenço; Lino Gonçalves; em Nome Dos Investigadores do Registo Nacional de Síndromes Coronárias Agudas

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Background:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> The role of coronary artery bypass-graft (CABG) versus percutaneous coronary intervention (PCI) in diabetes mellitus (DM) patients is well stablished for patients with multivessel chronic coronary artery disease. However, in the context of non-ST elevation acute coronary syndrome (NST-ACS), few data are available comparing both strategies. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Aim:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> To assess the prognostic impact of CABG vs PCI in DM patients presenting with NST-ACS on intrahospital outcomes. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> <span style="color:#201f1e">32027 </span>ACS patients included in the Portuguese Registry of Acute Coronary Syndromes (2010-2021) were retrospectively assessed. Clinical, laboratorial, and echocardiographic data were evaluated. Diabetic patients presenting with non-ST elevation ACS were screened (n=<span style="color:#201f1e">6368). After excluding patients with previous CABG, significant valvular disease, single vessel disease, medically treated only, 1799 patients were included. Two groups were created based on the revascularization strategy: Group A &ndash; CABG (n=535) and group B &ndash; PCI (n=</span>1264<span style="color:#201f1e">). The primary endpoint was in-hospital mortality. In-hospital complications were also analysed and compared between groups to better understand the course of hospitalization in both revascularization strategies.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#201f1e">Results: P</span></span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#201f1e">atients treated with CABG were more likely to be male (73,6% vs 67,3%, P&lt;0.05) and younger (68&plusmn;10 <em>vs</em> 69&plusmn;10 years old, P&lt;0.05). Also, previous MI (21,6% vs 27,6%, P&lt;0.05) or PCI (14,9% vs 24,3%, P&lt;0.001) were less prevalent in CABG group while peripheral artery disease was more prevalent (12,6% vs 9,3%, P&lt;0.05). Groups were comparable regarding CV risk factors and other past medical history. Also, echocardiographic, and laboratorial data did not differ between groups. The need for IABP, mechanical invasive or non-invasive ventilation, temporary pacemaker or ventricular assistance was similar in both groups. Patients admitted in KK IV class were more likely to receive PCI (0.4% vs 1.8%, P&lt;0.05), while patients with mechanical complications were more likely to be treated with CABG. Reinfarction was more frequent in the PCI group. In-hospital complications are detailed in table 1. Twenty-one patients died during hospitalization. In-hospital mortality was 1.2% and it did not differ with the revascularization strategy (1.1% vs 1.2%, P=0.91). </span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#201f1e">Conclusion:</span></span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#201f1e"> For diabetic patients with NST-ACS and multivessel disease, CABG and PCI have comparable in-hospital mortality.</span></span></span></span></span></p>