Evidence mapPaperPMID 34405232Full record

Trial reportEuropean heart journal2021

Ten-year all-cause death after percutaneous or surgical revascularization in diabetic patients with complex coronary artery disease.

Rutao Wang, Patrick W Serruys, Chao Gao, Hironori Hara, Kuniaki Takahashi, Masafumi Ono, Hideyuki Kawashima, Neil O'leary, David R Holmes, Adam Witkowski and 13 more

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
6.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00114972 phase3unknown statusnot on this map

SYNTAX Study: SYNergy Between PCI With TAXUS and Cardiac Surgery

TypeinterventionalSponsorBoston Scientific CorporationRan2005 to 2012Enrolled1,800ConditionsCoronary Artery DiseaseArmsPolymer-based Paclitaxel-Eluting TAXUS Express2-SR Stent, Coronary Artery Bypass Surgery
NCT03417050 completednot on this map

Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival

TypeobservationalSponsorErasmus Medical CenterRan2016 to 2019Enrolled2,636ConditionsCoronary Artery DiseaseArmsNo intervention will take place for this retrospective and observational study.
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.

  1. Pooled it
  2. Impact of repeat revascularization within 5 years on 10-year mortality after percutaneous or surgical revascularization.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
    Trial
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  18. Impact of periprocedural major adverse events on 10-year mortality after revascularisation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 12 institutions in 9 countries.

Rutao WangDepartment of Cardiology, Xijing Hospital, Changle West Road 127, Xi'an 710032, China.
Patrick W SerruysDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.ORCID 0000-0002-9636-1104
Chao GaoDepartment of Cardiology, Xijing Hospital, Changle West Road 127, Xi'an 710032, China.ORCID 0000-0002-0390-8060
Hironori HaraDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
Kuniaki TakahashiDepartment of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0001-5748-7700
Masafumi OnoDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.ORCID 0000-0002-3919-5648
Hideyuki KawashimaDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
Neil O'learyDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
David R HolmesDepartment of Cardiology, Mayo ClinicSchool of Medicine, 200 First St. SW Rochester, MN 55905, USA.ORCID 0000-0002-0037-0373
Adam WitkowskiDepartment of Interventional Cardiology and Angiology, National Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland.ORCID 0000-0002-3514-2047
Nick CurzenCardiology Department, University Hospital Southampton, Coxford Rd, Southampton SO16 5YA, UK.ORCID 0000-0001-9651-7829
Francesco BurzottaInstitute of Cardiology, Catholic University of the Sacred Heart, Largo F. Vito 1, Rome 00168, Italy.ORCID 0000-0002-6569-9401
Stefan JamesDepartment of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Dag Hammarskjolds vag 14B SE-752 37, Uppsala, Sweden.
Robert-Jan van GeunsDepartment of Cardiology, Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands.
Arie Pieter KappeteinDepartment of Cardiothoracic Surgery, Erasmus University Medical Centre, Dr Molewaterplein 40, 3015 GE Rotterdam, The Netherlands.ORCID 0000-0003-3545-2229
Marie-Angele MorelDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
Stuart J HeadDepartment of Cardiothoracic Surgery, Erasmus University Medical Centre, Dr Molewaterplein 40, 3015 GE Rotterdam, The Netherlands.
Daniel J F M ThuijsDepartment of Cardiothoracic Surgery, Erasmus University Medical Centre, Dr Molewaterplein 40, 3015 GE Rotterdam, The Netherlands.ORCID 0000-0003-4855-4996
Piroze M DavierwalaDepartment of Cardiac Surgery, Heart Centre Leipzig, Strumpelstrasse 39, Leipzig 4289, Germany.
Timothy O'BrienRegenerative Medicine Institute, CURAM, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
Valentin FusterDivision of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicina at Mount Sinai School, 1 Gustave L. Levy Place, 10029-5674 New York, NY, USA.
Scot GargDepartment of Cardiology, East Lancashire Hospitals NHS Trust, Haslingden Rd, Blackburn BB2 3HH, Lancashire, UK.ORCID 0000-0002-8911-0278
Yoshinobu OnumaDepartment of Cardiology, National University of Ireland, Galway (NUIG), University Road, Galway H91 TK33, Ireland.
Ollscoil na Gaillimhe – University of Galway · IEErasmus University Rotterdam · NLRadboud University Nijmegen · NLAmsterdam UMC Location University of Amsterdam · NLEast Lancashire Hospitals NHS Trust · GBIcahn School of Medicine at Mount Sinai · USInstitute of Cardiology · PLLeipzig Heart Institute · DEMayo Clinic · USUniversità Cattolica del Sacro Cuore · ITUniversity Hospital Southampton NHS Foundation Trust · GBUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this article was to compare rates of all-cause death at 10 years following coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in patients with or without diabetes. METHODS AND

resultsThe SYNTAXES study evaluated up to 10-year survival of 1800 patients with three-vessel disease (3VD) and/or left main coronary artery disease (LMCAD) randomized to receive either PCI or CABG in the SYNTAX trial. Ten-year all-cause death according to diabetic status and revascularization strategy was examined. In diabetics (n = 452), the risk of mortality was numerically higher with PCI compared with CABG at 5 years [19.6% vs. 13.3%, hazard ratio (HR): 1.53, 95% confidence interval (CI): 0.96, 2.43, P = 0.075], with the opposite seen between 5 and 10 years (PCI vs. CABG: 20.8% vs. 24.4%, HR: 0.82, 95% CI: 0.52, 1.27, P = 0.366). Irrespective of diabetic status, there was no significant difference in all-cause death at 10 years between patients receiving PCI or CABG, the absolute treatment difference was 1.9% in diabetics (PCI vs. CABG: 36.4% vs. 34.5%, difference: 1.9%, 95% CI: -7.6%, 11.1%, P = 0.551). Among insulin-treated patients (n = 182), all-cause death at 10 years was numerically higher with PCI (47.9% vs. 39.6%, difference: 8.2%, 95% CI: -6.5%, 22.5%, P = 0.227).

conclusionsThe treatment effects of PCI vs. CABG on all-cause death at 10 years in patients with 3VD and/or LMCAD were similar irrespective of the presence of diabetes. There may, however, be a survival benefit with CABG in patients with insulin-treated diabetes. The association between revascularization strategy and very long-term ischaemic and safety outcomes for patients with diabetes needs further investigation in dedicated trials.

trial registrationSYNTAX: ClinicalTrials.gov reference: NCT00114972 and SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050.

Indexed as

Coronary Artery DiseaseDiabetes MellitusPercutaneous Coronary InterventionCoronary Artery BypassHumansTreatment OutcomeVascular Surgical ProceduresAll-cause deathCoronary artery bypass graftingDiabetesPercutaneous coronary interventionSYNTAX

Identifiers

PMID34405232
PMCPMC8720143
OpenAlexW3195309976

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.