{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:44:52Z","timestamp":1793832292078,"version":"4.6.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Several trials reported differential outcomes after percutaneous coronary intervention with drug\u2010eluting stents (DES) and coronary\u2010artery bypass grafting (CABG) for multivessel coronary disease according to the presence of diabetes mellitus (DM). However, it is not well recognized how DM status affects very\u2010long\u2010term (10\u2010year) outcomes after DES and CABG for left main coronary artery disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In the PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery versus Angioplasty using Sirolimus\u2010Eluting Stent in Patients with Left Main Coronary Artery Disease) trial, patients with LMCA were randomly assigned to undergo PCI with sirolimus\u2010eluting stents (n=300) or CABG (n=300). The primary outcome was the incidence of major adverse cardiac or cerebrovascular events (MACCE; a composite of death from any cause, myocardial infarction, stroke, or ischemia\u2010driven target\u2010vessel revascularization). Outcomes were examined in patients with (n=192) and without (n=408) medically treated diabetes. The follow\u2010up was extended to at least 10\u00a0years for all patients (median, 11.3\u00a0years). The 10\u2010year rates of MACCE were not significantly different between DES and CABG in patients with DM (36.3% versus 26.7%, respectively; hazard ratio [HR], 1.35; 95% CI, 0.83\u20132.19;\n              <jats:italic>P<\/jats:italic>\n              =0.23) and without DM (25.3% versus 22.9%, respectively; HR, 1.15; 95% CI, 0.79\u20131.67;\n              <jats:italic>P<\/jats:italic>\n              =0.48) (\n              <jats:italic>P<\/jats:italic>\n              \u2010for\u2010interaction=0.48). There were no significant between\u2010group differences in composite of death, MI, or stroke, and all\u2010cause mortality, regardless of DM status. TVR rates were consistently higher after DES than CABG.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this 10\u2010year extended follow\u2010up of PRECOMBAT, we found no significant difference between DES and CABG with respect to the incidences of MACCE, serious composite outcome, and all\u2010cause mortality in patients with and without DM with LMCA disease. However, owing to the limited number of patients and no adjustment for multiple testing, overall findings should be considered hypothesis\u2010generating, highlighting the need for further research.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03871127 and NCT00422968.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019834","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T08:58:03Z","timestamp":1625821083000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Ten\u2010year Outcomes After Drug\u2010Eluting Stents or Bypass Surgery for Left Main Coronary Disease in Patients With and Without Diabetes Mellitus: The PRECOMBAT Extended Follow\u2010Up Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5599-758X","authenticated-orcid":false,"given":"Yeong Jin","family":"Jeong","sequence":"first","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4031-391X","authenticated-orcid":false,"given":"Jung\u2010Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4211-3081","authenticated-orcid":false,"given":"Junho","family":"Hyun","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0617-3116","authenticated-orcid":false,"given":"Junghoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Hyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical CenterUniversity of Ulsan College of Medicine Seoul 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