Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft In- hospital Outcomes in Diabetes

Background Despite extensive research on coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI) outcome differences, current literature lacks representation of short-term in-hospital outcomes in patients with existing medical conditions. This study aimed to compare perioperative outcomes of these two revascularization procedures in diabetes mellitus (DM) patients. Methods The National Inpatient Sample (NIS) was used to extract patients who received CABG or PCI surgery between the last quarter of 2015 to 2020 based on ICD10-PCS. Patients of age<40 were excluded for congenital heart defects. Preoperative differences were noted and adjusted using multivariable logistic regression. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were estimated between PCI and CAGB groups. Results A total number of 90,662 CABG and 173,725 PCI cases of patients with DM were identified in NIS. Compared to CABG, patients who underwent PCI had increased mortality (2.75% vs 2.00%, aOR 1.266, p<0.0001), myocardial infarction (1.5% vs 1.17%, aOR 1.223, p<0.0001), and were less likely to experience respiratory events (0.38% vs 6.33%, aOR 0.055, p<0.0001), stroke (0.03% vs 0.06%, aOR 0.385, p<0.0001), acute kidney injury (20.37% vs 25.37%, aOR 0.727, p<0.0001), sepsis (0.01% vs 0.05%, aOR 0.172, p<0.0001), shock (0.11% vs 0.74%, aOR 0.139, p<0.0001). Conclusions The NIS database collects enormous records from nationwide providers, offering great statistical power. PCI was associated with a markedly higher in-hospital mortality rate but a lower morbidity rate in patients with DM as compared to CABG. Therefore, physicians should weigh both mortality and morbidity when considering surgical treatment to DM patients.