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Coronary revascularisation in patients with diabetes: a chance to be better
Commentary on: Farkouh ME, Domanski M, Sleeper LA, et al.. Strategies for multivessel revascularisation in patients with diabetes. N Engl J Med 2012;367:2375–84. Context In 2009, a pooled analysis of individual patient data from randomised clinical trials comparing percutaneous coronary interventions (PCI) with coronary artery bypass grafting (CABG) showed a survival benefit in favour of CABG.1 Techniques of both PCI and CABG evolved during the last decade with the use of drug-eluting stents (DES) and novel antiplatelet agents. Methods In the FREEDOM trial, patients with diabetes and multivessel coronary artery disea...
Source: Evidence-Based Medicine - November 21, 2013 Category: Internal Medicine Authors: Windecker, S., Stefanini, G. G. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease Therapeutics Source Type: research

Bypass surgery is more cost-effective than percutaneous coronary interventions for most patients with multivessel or left main coronary artery disease
Commentary on: Cohen DJ, Osnabrugge RL, Magnuson EA, et al; SYNTAX Trial Investigators. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents versus bypass surgery for patients with 3-vessel or left main coronary artery disease: final results from the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation 2014;130:1146–57. Context The SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) trial compared outcomes of percutaneous coronary intervention (PCI) with drug eluting stents (DES) and coronary a...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Agarwal, S., Kapadia, S. R. Tags: Health policy, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Health economics, Health service research Economic analysis Source Type: research

Coronary artery bypass surgery continues to remain the treatment of choice for multivessel coronary artery disease even in the era of new-generation drug-eluting stents
Commentary on: Park SJ, Ahn JM, Kim YH, et al; BEST Trial Investigators. Trial of everolimus-eluting stents or bypass surgery for coronary disease. N Engl J Med 2015;372:1204–12. Context Multivessel coronary artery disease (MVCAD) may be found in patients subjected to coronary angiography. It is treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). The expanded use of PCI, following development of drug-eluting stents (DES), necessitated comparison of its outcomes with CABG (gold standard therapy). The SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) trial favoured...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Mohr, F. W., Davierwala, P. M. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research