Strategies for multivessel revascularization in patients with diabetes.
Evaluation of: Farkouh ME, Domanski M, Sleeper LA et al. Strategies for multivessel revascularization in patients with diabetes. N. Engl. J. Med. 367, 2375-2384 (2012). The FREEDOM trial enrolled 1900 patients with diabetes and multivessel coronary disease to percutaneous coronary intervention (PCI) with drug-eluting stents or coronary artery bypass grafting (CABG). In the drug-eluting stents arm, 94% were treated with the first-generation drug-eluting stents. The median duration of follow-up among survivors was 3.8 years. The primary outcome, a composite of death from any cause, nonfatal myocardial infarction or nonfatal stroke, occurred more frequently in the PCI group, with 5-year rates of 26.6% in the PCI group and 18.7% in the CABG group, a statistically significant relative-risk reduction of 30%. Stroke rates were significantly higher in the CABG group, with 5-year rates of 2.4% in the PCI group and 5.2% in the CABG group.
Cardiovascular Center, Chungnam National University Hospital, 282 Munhwa-ro, Daejeon 301-721, Korea.
Jae-Hwan
JH
Lee
Seung-Whan
SW
Lee
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D009204:Myocardial Revascularization / Q000379:methods* / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D040242:Risk Reduction Behavior; D020521:Stroke / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors