• Press Release

Patients With Diabetes and Advanced Heart Disease Lived Longer After Bypass Surgery Than Those Treated With Angioplasty

Greatest benefit in patients under 65 in highly anticipated eight-year final survival report for FREEDOM study

  • New York, NY
  • (November 11, 2018)

Patients who have diabetes and multivessel coronary artery disease that is treated with coronary-artery bypass grafting (CABG) survived about three years longer than similar patients who were treated with percutaneous coronary intervention with drug-eluting stents (PCI), researchers from the Icahn School of Medicine at Mount Sinai have found.

The mortality rate from all causes was significantly higher in the PCI group (24.31 percent) compared with the CABG group (18.3 percent) among 943 patients who were followed for eight years. More patients under 65 from the CABG group remained alive after eight years. This is the first study to demonstrate the long-term mortality benefit of CABG compared with PCI, a minimally invasive procedure commonly known as angioplasty, and to show that the greatest benefit is in patients under 65 years old.

Results of the FREEDOM Follow-on Study were presented as a late breaker at the American Heart Association Annual Scientific Sessions on Sunday, November 11, in Chicago and published simultaneously in the Journal of the American College of Cardiology.

The FREEDOM Follow-on Study is the final long-term follow-up report of the landmark FREEDOM (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) trial. After completion of the original FREEDOM trial in 2012, 25 international centers participated in the follow-on study.

Heart disease is the leading cause of morbidity and mortality in individuals with Type 2 diabetes.

“Treating people with diabetes and heart disease presents unique challenges due to increased risk for death, heart attack, and stroke,” said the study’s principal investigator, Valentin Fuster, MD, PhD, Director, Mount Sinai Heart, and Physician-in-Chief of The Mount Sinai Hospital. “The FREEDOM trial and Follow-on Study firmly establishes a standard of care for this high-risk population.”

Although further advances in PCI have been made since the original FREEDOM trial, the data support CABG over PCI in patients with stable coronary artery disease and diabetes.

“These findings provide clear evidence that CABG plus standard medical therapy is the optimal treatment path for patients with diabetes and extensive coronary disease,” said Michael Farkouh, MD, the Peter Munk Chair in Multinational Clinical Trials at the University of Toronto, adjunct scientist at the Icahn School of Medicine at Mount Sinai, and the co-principal investigator of the FREEDOM trial and FREEDOM Follow-on Study.

Other Mount Sinai researchers who participated in the study included George Dangas, MD, PhD, Professor of Medicine (Cardiology) and Surgery at the Icahn School of Medicine and Director of Cardiovascular Innovation at the Zena and Michael A. Wiener Cardiovascular Institute, and Samin Sharma, MD, Director of Clinical and Interventional Cardiology, The Mount Sinai Hospital.

Other institutions involved in this research include the University of Toronto.

About the Mount Sinai Health System

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.

Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 11 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2023-2024.

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