An international, clinical research trial has shown that patients with diabetes whose multi-vessel coronary artery disease is treated with bypass surgery live longer and are less likely to suffer severe complications like heart attacks than those who undergo angioplasty.
“We’ve shown that bypass surgery saves one extra life for every 20 patients with diabetes who are treated for multi-vessel coronary artery disease,” says lead author, Dr. Michael Farkouh, Chair of the Peter Munk Centre of Excellence in Multinational Clinical Trials, Peter Munk Cardiac Centre, UHN.
Based on these results, Dr. Farkouh believes that coronary artery bypass surgery should be standard therapy for the millions of patients worldwide with diabetes who have more than one diseased vessel.
Coronary artery disease is the buildup of plaque in the coronary arteries. It’s the most common form of heart disease and can lead to chest pain, heart failure and heart attack. According to the Public Health Agency of Canada, almost 2.4 million Canadians live with diabetes.
The study – co-led by researchers at New York’s Mount Sinai Hospital and Toronto’s Peter Munk Cardiac Centre, University Health Network (UHN) – is known as the FREEDOM trial.
"This study will challenge the prevailing ambiguity between bypass surgery and angioplasty for multi-vessel coronary artery disease,” says Dr. Farkouh. “Bypass surgery saves lives and reduces the chance of complications in a high-risk group of patients with diabetes.”
The study focused on diabetes because patients with diabetes have cardiac events more often than patients who do not have diabetes, and require more follow-up care than other patients.
Cardiovascular disease is a major complication of diabetes and the leading cause of early death among people with this disease — about 65% of people with diabetes die from heart disease and stroke. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes.