Difference in the mortality of the CABRI diabetic and nondiabetic populations and its relation to coronary artery disease and the revascularization mode☆
Section snippets
Study population
The study population was that of the CABRI trial. Over 53 months starting in July 1988, 1,054 patients in 26 cardiothoracic centers throughout Europe were recruited. Five hundred forty-two underwent PTCA, of whom 522 had initially been randomized to PTCA and 20 to CABG. Four hundred ninety-three underwent CABG, of whom 478 had initially been randomized to CABG and 15 to PTCA. There were 125 diabetics (insulin and non–insulin dependent) in the CABRI. The inclusion criteria, exclusion criteria,
Demographic and baseline risk factor profile of diabetics and nondiabetics
There were no differences in the age and gender distributions; the mean age of the diabetics was 61.0 years and 75.2% were men; the mean age of the nondiabetics was 59.9 years and 78.3% were men. Diabetics were evenly randomized to PTCA (49.6%) and CABG (50.4%), as were the nondiabetics to PTCA (50.7%) and to CABG (49.3%). The baseline risk profile was comparable in diabetics and nondiabetics. There were no significant differences in the frequency of hypertension, hypercholesterolemia, smoking,
Discussion
The CABRI results indicate that diabetics had a significantly greater 4-year mortality than nondiabetics. Within either the diabetic or nondiabetic group, there was no significant mortality difference between those randomized to PTCA versus those to CABG. When stratified by revascularization mode, both diabetics randomized to PTCA and diabetics randomized to CABG had a higher mortality than respective nondiabetics; this association reached statistical significance only for the former.
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The CABRI trial was sponsored by educational and research grants from CR Bard (USCI) Inc., Minneapolis, Minnesota; The World Health Organization, Geneva, Switzerland; and The European Society of Cardiology, Sophia Antipolis, France. However, most of the funding was at the expense of, and due to the enthusiasm from, the individual participating centers whose imagination and perseverance made the CABRI trial possible. Manuscript received August 25, 2000; revised manuscript received and accepted October 30, 2000.