November 5, 2012
Cardiac Bypass Surgery Patients Experience Better Outcome Ultimately
Lee Rannals for redOrbit.com - Your Universe OnlineNew England Journal of Medicine that adults with diabetes and multi-vessel coronary heart disease who had the surgery had a better overall heart-related outcome than those who underwent an artery-opening procedure.
The study compared the effectiveness of coronary artery bypass graft (CABG) surgery with a non-surgical procedure known as percutaneous coronary intervention (PCI) that included insertion of drug-eluting stents.
"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 Gary H. Gibbons, M.D., director of the NIH/National Heart, Lung and Blood Institute (NHLBI).
In coronary heart disease, plaque builds up inside coronary arteries, which leads to blocked or reduced blood flow to the heart muscle. In 2010, about 380,000 Americans died from coronary heart disease.
About 25 to 30 percent of patients needing CABG or PCI have diabetes and multi-vessel coronary heart disease. In the U.S., over a million procedures are performed each year to restore circulation to patients with blocked arteries.
The study involved 140 centers and about 1,900 adults enrolled from 2005 to 2010. The participants had diabetes and coronary heart disease that involved narrowing of multiple blood vessels.
Each of the clinical sites had a team of specialists in neurology, heart disease, diabetes and general medicine. Those patients selected for the trial were randomly assigned to receive one of the surgeries.
During the trial, the participants received standard medical care for all major cardiovascular risk factors. They were also counseled about lifestyle choices like smoking, diet and exercise.
After five years, the CABG group had a lower combined rate of strokes, heart attacks and deaths than the PCI group.
"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 principal investigator Valentin Fuster.