Stenting May Equal Bypass for Diabetic Heart Patients

Nov. 26 -- WEDNESDAY, Nov. 25 (HealthDay News) -- In diabetic patients with blocked coronary arteries, there appears to be no difference in outcomes at one year whether patients undergo bypass surgery or angioplasty with stenting, British researchers report.

Bypass surgery has been the standard treatment for diabetic patients with coronary artery disease. However, less invasive approaches such as angioplasty with stenting -- where a thin mesh tube is inserted to open the artery -- have emerged. Until now, there's been little study to see whether the procedure is as effective as bypass in diabetic patients.

"Cardiovascular disease is the leading cause of death among patients with type 2 diabetes, and approximately 25 percent of the patients who undergo revascularization procedures in the United States have type 2 diabetes," noted Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, who was not involved in the study.

Earlier studies have suggested that bypass surgery provides more effective revascularization (re-opening of blood flow) and better long-term clinical outcomes in patients with type 2 diabetes and multi-vessel coronary artery disease compared to angioplasty/stenting, Fonarow said.

But this new clinical trial in patients with type 2 diabetes and multi-vessel disease suggests that in the first year at least, bypass and angioplasty/stenting produce similar results, he said.

"However, as this study is small and the follow-up period confined only to the first year, additional studies with more patients and longer-term follow-up are required," Fonarow said.

The report is published in the Nov. 25 online edition of the Journal of the American College of Cardiology. The study was funded by a number of drug companies, including Eli Lilly & Co. and Bristol-Myers Squibb, as well as stent manufacturers such as Boston Scientific and Medtronic.

For the study, a team led by Dr. Kevin J. Beatt from the Mayday University Hospital in London, randomly assigned 510 diabetic patients who participated in the Coronary Artery Revascularization in Diabetes Trial to undergo coronary bypass surgery or angioplasty with stenting.