Heart disease patients with diabetes fare better if they undergo coronary artery bypass surgery rather than angioplasty to insert a stent, new research has found.
By analyzing a series past studies comparing the two procedures, medical investigators at St. Michael's Hospital determined diabetics have a 30 percent less chance of dying after bypass surgery than a stent operation.
"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 Subodh Verma, M.D., a cardiac surgeon and lead author of the paper, published online in the journal Lancet Diabetes and Endocrinology.
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 researchers said.
Dr. Verma and colleagues said it's not clear why diabetic patients live longer after bypass surgery. But they speculated it may be because diabetics have extensive and diffuse blood-vessel blockages that are best treated by bypassing those areas altogether.
"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."
This study was funded by the Canadian Institutes for Health Research, the Heart and Stroke Foundation of Canada, and the Canada Research Chairs program.
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