Featured Research

from universities, journals, and other organizations

30 percent lower risk of dying for diabetics with bypass surgery

Date:
September 12, 2013
Source:
St. Michael's Hospital
Summary:
People with diabetes have a 30 percent less chance of dying if they undergo coronary artery bypass surgery rather than opening the artery through angioplasty and inserting a stent, a new study has found.

Study finds 30 per cent lower risk of dying for people with diabetes who undergo coronary artery bypass surgery vs. having stent installed.
Credit: Dr. Subodh Verma

People with diabetes have a 30 per cent less chance of dying if they undergo coronary artery bypass surgery rather than opening the artery through angioplasty and inserting a stent, a new study has found.

The findings are significant and have public health implications because of the sheer size of the difference in outcomes, according to the researchers at St. Michael's Hospital. Heart disease is the No. 1 killer of people with diabetes, and diabetics represent one-quarter of all patients who undergo coronary artery procedures. The number of people with diabetes is rising steadily as the population ages and becomes more sedentary.

"Although bypass surgery is more invasive than stenting, it is imperative that physicians and patients realize that long term mortality reduction is best achieved with bypass surgery," said Dr. Subodh Verma, a cardiac surgeon and principal author of the paper.

Whether diabetics fare better under coronary artery bypass surgery, known as CABG, or the angioplasty-stent procedure known as percuataneous coronary intervention, or PCI, has been the topic of intense debate, particularly from a scientific, social and financial perspective. Therefore, Dr. Verma and Dr. Jan Friedrich, an intensivist at St. Michael's, decided to conduct a meta-analysis of all existing randomized control trials comparing the two procedures. Their results appeared online in the journal Lancet Diabetes and Endocrinology on Friday.

It's not known exactly why diabetic patients live longer after bypass surgery compared to stents, even in the contemporary age of "drug-eluting stents," which are coated with medication that is slowly released to help prevent the growth of scar tissue in the artery lining. Dr. Verma said it may be related to the fact that diabetics have extensive and diffuse blockages that are best treated by bypassing those areas altogether.

They also found that while patients with diabetes did better with CABG, the procedures was associated with an increased risk of non-fatal strokes. They said this may be related to the fact the heart has to be stopped during the procedure.

"The study represents an important call to action for physicians and patients," Dr. Verma said. "Physicians must disclose this benefit to the patient to truly obtain informed consent."

He noted that the decision to recommend whether diabetic patients undergo one procedure rather than the other usually resides with the cardiologist, who performs stenting. Bypasses are performed by cardiac surgeons.

"Despite guidelines from the American Heart Association and the American College of Cardiology advocating for bypasses over stents, until joint decision-making between a cardiologist and cardiac surgeon is facilitated, these findings will be difficult to translate into clinical practice."

The European Society of Cardiology supports the concept of a Heart Team, whereby a surgeon, interventionalist, cardiologist and other specialties work together to decide on needed treatment.


Story Source:

The above story is based on materials provided by St. Michael's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Subodh Verma, Michael E Farkouh, Bobby Yanagawa, David H Fitchett, Muhammad R Ahsan, Marc Ruel, Sachin Sud, Milan Gupta, Shantanu Singh, Nandini Gupta, Asim N Cheema, Lawrence A Leiter, Paul W M Fedak, Hwee Teoh, David A Latter, Valentin Fuster, Jan O Friedrich. Comparison of coronary artery bypass surgery and percutaneous coronary intervention in patients with diabetes: a meta-analysis of randomised controlled trials. The Lancet Diabetes & Endocrinology, 2013; DOI: 10.1016/S2213-8587(13)70089-5

Cite This Page:

St. Michael's Hospital. "30 percent lower risk of dying for diabetics with bypass surgery." ScienceDaily. ScienceDaily, 12 September 2013. <www.sciencedaily.com/releases/2013/09/130912203317.htm>.
St. Michael's Hospital. (2013, September 12). 30 percent lower risk of dying for diabetics with bypass surgery. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2013/09/130912203317.htm
St. Michael's Hospital. "30 percent lower risk of dying for diabetics with bypass surgery." ScienceDaily. www.sciencedaily.com/releases/2013/09/130912203317.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins