Creating a free account will enable you to subscribe to our daily and weekly email newsletters, as well as customize your reading experience to show only the categories most relevant to you.
Signing up only take a few minutes, so why not give it a try and see what you've been missing out on.
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 coasted 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.
This study was funded by the Canadian Institutes for Health Research, the Heart and Stroke Foundation of Canada and the Canada Research Chairs program.
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our Diabetes category page for the latest news on this subject.
Please use one of the following formats to cite this article in your essay, paper or report:
Hospital, St. Michael's. "Study finds 30 percent lower risk of dying for diabetics with bypass surgery vs. stent." Medical News Today. MediLexicon, Intl., 17 Sep. 2013. Web.
5 Dec. 2013. <http://www.medicalnewstoday.com/releases/266094>
Hospital, S. (2013, September 17). "Study finds 30 percent lower risk of dying for diabetics with bypass surgery vs. stent." Medical News Today. Retrieved from
Please note: If no author information is provided, the source is cited instead.
If you write about specific medications, operations, or procedures please do not name healthcare professionals by name.
For any corrections of factual information, or to contact the our editorial team, please use our feedback form. Please send any medical news or health news press releases to:
Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.
This page was printed from: http://www.medicalnewstoday.com/releases/266094.php
Visit www.medicalnewstoday.com for medical news and health news headlines posted throughout the day, every day.
© 2004-2013 All rights reserved. MNT (logo) is the registered trade mark of MediLexicon International Limited.