Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With 3‐Vessel Coronary Artery Disease and Diabetes
Bibliographic record
Abstract
Background Coronary artery bypass grafting (CABG) has been associated with reduced mortality, myocardial infarction, and repeat revascularization compared with percutaneous coronary intervention (PCI) for patients with 3‐vessel coronary artery disease (CAD) and diabetes. The majority of previous studies have been limited to follow‐up of <10 years. Herein, we compared CABG and PCI in patients with 3‐vessel coronary artery disease and diabetes with a maximum long‐term follow‐up of 14 years. Methods Patients with diabetes and 3‐vessel coronary artery disease but without ST‐segment–elevation myocardial infarction who underwent coronary angiography followed by CABG or PCI from 2009 to 2018 were included in this study. The primary outcome was mortality, and the secondary outcomes included myocardial infarction, stroke, or repeat revascularization. Outcomes were adjusted for age, sex, and clinical comorbidities. Results A total of 1210 patients underwent PCI (median follow‐up, 9.1 years) while 477 underwent CABG (median follow‐up, 8.1 years). Patients who underwent CABG were less likely to experience mortality (49.6% versus 57.6%, P =0.003, adjusted hazard ratio [aHR], 0.75 [95% CI, 0.61–0.91]), myocardial infarction (15.6% versus 28.1%, P <0.001, aHR, 0.45 [95% CI, 0.33–0.61]), or require repeat revascularization (7.7% versus 26.9%, P <0.001, aHR, 0.21 [95% CI, 0.14–0.30]) at longest follow‐up. Risk of rehospitalization (82.6% versus 83.4%, P =0.656) and stroke (11.6% versus 12.2%, P =0.794) did not significantly differ between groups. Conclusions In this study, we describe one of the longest follow‐up periods for patients with diabetes and 3‐vessel coronary artery disease who underwent CABG or PCI and confirmed that the shorter‐term benefits seen in randomized trials do translate into longer‐term reductions in risk of death, myocardial infarction, or repeat revascularization.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".