Featured Research

from universities, journals, and other organizations

For diabetics, angioplasty and bypass surgery lead to similar long-term benefits

Date:
October 15, 2013
Source:
American Medical Association (AMA)
Summary:
For patients with diabetes and coronary artery disease in more than one artery, treatment with coronary artery bypass graft surgery provided slightly better health status and quality of life between 6 months and 2 years than procedures using drug-eluting stents, although beyond 2 years the difference disappeared.

For patients with diabetes and coronary artery disease in more than one artery, treatment with coronary artery bypass graft surgery provided slightly better health status and quality of life between 6 months and 2 years than procedures using drug-eluting stents, although beyond 2 years the difference disappeared, according to a study in the October 16 issue of JAMA.

Related Articles


Although previous studies have demonstrated that coronary artery bypass graft (CABG) surgery is generally preferred over percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) for patients with diabetes mellitus and coronary artery disease in more than one artery, these studies were based largely on older data from when angioplasty and stents were different. Recently, the FREEDOM trial demonstrated that for this group of patients, CABG surgery resulted in lower rates of death and heart attack but a higher risk of stroke when compared with PCI using drug-eluting stents. Whether there are differences in health status assessed from the patient's perspective is unknown, according to background information in the article.

Mouin S. Abdallah, M.D., M.Sc., of Saint Luke's Mid America Heart Institute, Kansas City, and colleagues conducted a substudy of the FREEDOM trial to assess functional status and quality of life. Between 2005 and 2010, 1,900 patients from 18 countries with diabetes mellitus and multivessel coronary artery disease were randomized to undergo either CABG surgery (n = 947) or PCI (n = 953) as an initial treatment strategy. Of these, a total of 1,880 patients had baseline health status assessed (935 CABG, 945 PCI) and comprised the primary analytic sample.

The researchers found that at 2-year follow-up, measures of angina frequency, physical limitations, and quality-of-life indicated greater benefit of CABG compared to PCI. Beyond 2 years, the 2 revascularization strategies provided generally similar patient-reported outcomes.

The primary results of the FREEDOM trial demonstrated that for diabetic patients with multivessel coronary artery disease, CABG led to a benefit over PCI for the composite endpoint of death, myocardial infarction, or stroke, driven by reductions in both all-cause mortality and myocardial infarction. Although both revascularization strategies led to substantial and sustained improvements in quality of life and functional status in the FREEDOM trial, angina relief was slightly better with CABG than PCI, especially among patients with the most severe angina at baseline, the authors write.

These findings suggest that CABG could be preferred as the initial revascularization strategy for such patients. “Given the increased rate of stroke, as well as the well-recognized longer recovery period with CABG surgery, however, some patients who do not wish to face these acute risks may still choose the less invasive PCI strategy. For such patients, our study provides reassurance that there are not major differences in long-term health status and quality of life between the 2 treatment strategies. Nonetheless, it is important for patients to recognize that the similar late quality-of-life outcomes with PCI and CABG in the FREEDOM trial were achieved with higher rates of antianginal medication use and the need for more frequent repeat revascularization procedures among the PCI group.”


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. Mouin S. Abdallah. Quality of Life After PCI vs CABG Among Patients With Diabetes and Multivessel Coronary Artery Disease. JAMA, 2013; 310 (15): 1581 DOI: 10.1001/jama.2013.279208

Cite This Page:

American Medical Association (AMA). "For diabetics, angioplasty and bypass surgery lead to similar long-term benefits." ScienceDaily. ScienceDaily, 15 October 2013. <www.sciencedaily.com/releases/2013/10/131015191059.htm>.
American Medical Association (AMA). (2013, October 15). For diabetics, angioplasty and bypass surgery lead to similar long-term benefits. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2013/10/131015191059.htm
American Medical Association (AMA). "For diabetics, angioplasty and bypass surgery lead to similar long-term benefits." ScienceDaily. www.sciencedaily.com/releases/2013/10/131015191059.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Breakfast Debate: To Eat Or Not To Eat?

Breakfast Debate: To Eat Or Not To Eat?

Newsy (Oct. 23, 2014) Conflicting studies published in the same week re-ignited the debate over whether we should be eating breakfast. Video provided by Newsy
Powered by NewsLook.com
Ebola Fears Keep Guinea Hospitals Empty

Ebola Fears Keep Guinea Hospitals Empty

AP (Oct. 23, 2014) Fears of Ebola are keeping doctors and patients alike away from hospitals in the West African nation of Guinea. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Despite Rising Death Toll, Many Survive Ebola

Despite Rising Death Toll, Many Survive Ebola

AP (Oct. 23, 2014) The family of a Dallas nurse infected with Ebola in the US says doctors can no longer detect the virus in her. Despite the mounting death toll in West Africa, there are survivors there too. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
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