Pioneering surgical techniques are offering hope to diabetes patients who also have coronary artery disease. An American study has revealed that those patients who undergo a coronary artery bypass graft (CABG) do better afterwards than patients who undergo angioplasty.
Multivessel coronary artery disease is a life threatening narrowing or blockage in any of the four arteries that feed the heart and is a dangerous side effect of diabetes. Treatment usually involves an angioplasty in which a stent is used to widen the arteries to allow the blood to flow more freely. In CABG, a blood vessel is taken from another part of the body, usually the chest, leg or arm, and used to bypass the narrowed or blocked artery.
The US study was carried out at Roudebush VA Medical Centre in Indianapolis and reported in the Journal of the American College of Cardiology. It involved almost 200 patients who had diabetes and severe coronary artery disease. Each participant was randomly assigned to receive either CABG or angioplasty.
The study followed the patients for at least two years, measuring their outcomes following the surgery or angioplasty. However, the study had to stop early because it was unable to recruit the full sample size. Its authors admit this means the study fell short but insist that the results they revealed are still “meaningful”.
Their conclusion was that surgery was the best option for patients with diabetes who have multivessel coronary artery disease because the long-term outcome and prognosis for those patients was better than for those patients who have the angioplasty.
Their findings matched those of an earlier study, which was presented in 2012 and also reached the same conclusion – that surgery is the best option for patients with two or three-vessel coronary heart disease. The only exception for diabetic patients is for those who have just one blocked vessel where a stent can be most effective.
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