A new study has shown that bypass surgery for diabetics with clogged coronary arteries may be a better option than drug coated stents.
The 1,900-paitient clinical trial funded by the US National Institutes of Health found that after five years, diabetic patients who underwent coronary artery bypass surgery had a “statistically significant” lower combined rate of heart attack, stroke and death than those with implanted stents (18.7 per cent versus 26.6 per cent).
While previous studies have demonstrated the superiority of bypass surgery over the use of bare metal stents (small mesh tubes used to prop open blocked arteries), researchers from Mount Sinai School of Medicine in New York wanted to investigate whether newer stents coated with drugs to prevent reclogging offer any improvement.
Dr. Valentin Fuster, who presented the findings at the American Heart Association scientific meeting in Los Angeles, said the advantages seen in the trial were “striking” and “could change treatment recommendations for thousands of individuals with diabetes and heart disease”.
However, he warned that longer term follow-up of patients is needed to confirm the results.
“We always want to know how long the effects last,” he explained. “The gap [between bypass surgery and stenting] could begin to close or the results could get better and better. So, longer follow-up is critical.”
In the United States, more than one million bypass surgeries or stenting procedures are carried out each year. Of these, more than a quarter involve diabetic patients with multiple coronary blockages.
Bypass surgery requires taking healthy blood vessels from another part of the body and patching them onto the heart to restore blood flow around a clogged coronary artery, while stenting involves threading bare metal or medication-coated stents up into the arteries to improve blood flow.

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