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Int J Angiol 2021; 30(03): 187-193
DOI: 10.1055/s-0041-1735517
Review Article

CABG versus PCI in the Treatment of Unprotected Left Main Disease in Diabetics: A Literature Review

Daniel Lambert
1   Department of Cardiac Surgery, North Shore-Long Island Jewish Medical Center, Manhasset, New York
,
Allan Mattia
2   Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital, Manhasset, New York
3   Hofstra Northwell School of Medicine, Department of Surgery, Hempstead, New York
,
Angel Hsu
4   Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
,
Frank Manetta 
5   Department of Cardiothoracic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York
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Abstract

The approach to left main coronary artery disease (CAD) in diabetic patients has been extensively debated. Diabetic patients have an elevated risk of left main disease in addition to multivessel disease. Previous trials have shown increased revascularization rates in percutaneous coronary intervention compared with coronary artery bypass grafting (CABG) but overall comparable outcomes, although many of these studies were not using the latest stent technology or CABG with arterial revascularization. Our aim is to review the most recent trials that have recently published long-term follow-up, as well as other literature pertaining to left main disease in diabetic patients. Furthermore, we will be discussing some future treatment strategies that could likely create a paradigm shift in how left main CAD is managed.

Keywords

PCI - CABG - left main coronary artery disease - stent - acute coronary syndrome - coronary intervention - cardiac


Publication History

Article published online:
10 November 2021

© 2021. International College of Angiology. This article is published by Thieme.

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