A new study today revealed that adult patients with diabetes and multi-vessel coronary heart disease who had cardiac bypass surgery fared better in overall heart-related outcomes than those who had a non-surgical procedure called percutaneous coronary intervention (PCI). PCI involves the insertion of drug-eluting stents into the arteries of patients.
The study found that those who received coronary artery bypass graft (CABG) surgery had only an 18.7% combined rate of strokes, heart attacks, and deaths, while those who received PCI had a combined rate of 26.6%. Although the rate of stroke was higher for the CABG group (5.2%) than the PCI group (2.4%), 16.3% of people in the PCI group died of any cause, compared to only 10.9% of the CABG patients.
"These study results confirm that bypass surgery is a better overall treatment option for individuals with diabetes and multi-vessel coronary disease and may assist physicians' efforts to prevent cardiovascular events such as heart attacks and deaths in this high-risk group," said Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute.
The study, called Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM), was presented this week at the American Heart Association's annual meeting and published in The New England Journal of Medicine. It compared the effectiveness of PCI to that of CABG surgery. Researchers looked at 1,900 adults enrolled in the program at 140 international centers from 2005 to 2010. Each participant had diabetes and coronary heart disease that involved the narrowing of multiple blood vessels, but not the left main coronary artery. Eligible patients were randomly assigned either CABG or PCI, then had their health monitored for five years.
"The advantages of CABG over PCI were striking in this trial and could change treatment recommendations for thousands of individuals with diabetes and heart disease," said Dr. Valentin Fuster, principal investigator on the study and cardiologist at the Mount Sinai School of Medicine.