New Heart Study Shows Diabetic Patients With Multiple Blockages Live Longer With Bypass Than Stents

FREEDOM trial studies patients with diabetes and advanced multivessel coronary artery disease


April 8, 2013

April 8, 2013 — The FREEDOM trial, the first long-term, comparative study of its kind exclusively for patients with diabetes and advanced multivessel coronary artery disease (CAD) revealed that diabetics with CAD live longer and are less likely to suffer a non-fatal heart attack when treated with bypass surgery instead of drug-eluting stents (DES), tiny, medicine-coated mesh tubes that prop open clogged arteries.

People with diabetes mellitus, a disease that affects an estimated 14.5 million Americans, are at higher risk for death from coronary artery disease and face increased risks from procedures to treat CAD, according to the National Heart, Lung, and Blood Institute. The disease in diabetic patients progresses faster than CAD in people who do not have diabetes.
The study reviewed five-year outcomes from 2005 to 2010 at 140 international sites for a total of 1,900 patients with diabetes and multivessel CAD who underwent randomization between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with DES, also known as angioplasty. All patients were prescribed standard medical therapy for coronary artery disease and diabetes.
Michael E. Farkouh, M.D., in the conclusion of the article that was published in the New England Journal of Medicine wrote, "For patients with diabetes and advanced coronary artery disease, CABG was superior to PCI in that it significantly reduced rates of death and myocardial infarction, with a higher rate of stroke."  The study found that at five years the combined rate of death, myocardial infarction or stroke was 8 percent lower in CABG patients compared to PCI patients.
"The result of the FREEDOM trial is going to definitely establish CABG as the preferred treatment modality in high risk diabetic patients with multivessel coronary disease,” said Farzan Filsoufi, M.D., leading cardiothoracic surgeon at the Mount Sinai Medical Center.
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