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"AHA - CABG Still Better for Multivessel Disease in Diabetes" - Crystal Phend

  • MedPage Today
  • New York, NY
  • (November 12, 2018)

For diabetes patients with multivessel coronary disease (CAD), the survival advantage of coronary artery bypass grafting (CABG) over drug-eluting stents appears to have been sustained at 8 years, long-term follow-up of the FREEDOM trial found. Looking only at the 943 patients who entered the extended phase of follow-up -- the intent-to-treat primary outcome for the follow-up study -- showed similar numbers but without statistical significance, Valentin Fuster, MD, PhD, director of Mount Sinai Heart and physician in chief at the Mount Sinai Hospital, and colleagues reported at the American Heart Association Meeting and in the Journal of the American College of Cardiology. CABG appeared to benefit younger patients even more, with age ≤63.3 years at randomization being the only factor significantly associated with a differential effect of treatment strategy. Co-author George Dangas, MD, PhD, director of cardiovascular innovation at the Zena and Michael A. Weiner Cardiovascular Institute at The Mount Sinai Hospital, also questioned whether the gap may close in the future, but noted that it's just as likely to go on expanding. Ten or 20 years of follow-up may be "the next frontier," he said.

— Valentin Fuster, MD, PhD, Professor, Medicine, Cardiology, Icahn School of Medicine at Mount Sinai, Director, Mount Sinai Heart, Physician in Chief, The Mount Sinai Hospital
— George D. Dangas, MD, PhD, Professor, Medicine, Cardiology, Surgery, Icahn School of Medicine at Mount Sinai, Director, Cardiovascular Innovation, The Zena and Michael A. Weiner Cardiovascular Institute, The Mount Sinai Hospital

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