Furthermore, with the composite end point of death/MI/stroke there was no interaction between diabetics and non- diabetics with any of the revascularization strategies (p=0.65).
With introduction of drug eluting stents(DES) in clinical practice, superiority of effectiveness of DES over BMS have been largely demonstrated in head to head comparison in several RCT as well observational studies and meta-analysis 15-19, therefore, we would expect a substantial improving in PCI results over CABG narrowing the gap of recurrences in favor of CABG.
However, that was not the case and on the contrary all RCT and observational studies between DES and CABG showed that the gap in recurrences rate remained and there was also an unexpected increased rate of cardiac death and MI in patients treated with DES in both diabetic and non-diabetic populations 20-23. …show more content…
In recent years however, new generation DES significantly improved safety compared to the first one, in terms of stent mal-apposition and stent struts coverage which was reflected by a significant lower incidence of late and very late stent thrombosis as well for the requirements for long term dual antiplatelet therapy 25-27, although presence of neo-atherosclerosis remained
With introduction of drug eluting stents(DES) in clinical practice, superiority of effectiveness of DES over BMS have been largely demonstrated in head to head comparison in several RCT as well observational studies and meta-analysis 15-19, therefore, we would expect a substantial improving in PCI results over CABG narrowing the gap of recurrences in favor of CABG.
However, that was not the case and on the contrary all RCT and observational studies between DES and CABG showed that the gap in recurrences rate remained and there was also an unexpected increased rate of cardiac death and MI in patients treated with DES in both diabetic and non-diabetic populations 20-23. …show more content…
In recent years however, new generation DES significantly improved safety compared to the first one, in terms of stent mal-apposition and stent struts coverage which was reflected by a significant lower incidence of late and very late stent thrombosis as well for the requirements for long term dual antiplatelet therapy 25-27, although presence of neo-atherosclerosis remained