The study compared the effectiveness of coronary artery bypass graft (CABG) surgery with a non-surgical procedure known as percutaneous coronary intervention (PCI) that included insertion of drug-eluting stents. After five years, the CABG group had fewer adverse events and better survival rates than the PCI group.
In CABG, surgeons try to improve blood flow to the heart muscle by using a healthy artery or vein from another part of the body to bypass a blocked coronary artery.
PCI is a less invasive procedure in which blocked arteries are opened from the inside with a balloon. A stent, or small mesh tube, is then usually inserted to prop the opened arteries so that blood continues to flow into the heart muscle. The type of stent used in the study, called drug-eluting, is coated with medicine that is slowly and continuously released to prevent an opened artery from becoming blocked again.
The study, called Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM), involved 140 international centers and a total of 1,900 adults enrolled from 2005 to 2010. The participants had diabetes and coronary heart disease that involved narrowing of multiple blood vessels, but not the left main coronary artery, which usually requires immediate treatment with CABG.
At each clinical site, a team of specialists in neurology, heart disease, diabetes, and general medicine screened potential participants to ensure that they were eligible for both CABG and PCI. Those who were selected for the trial were randomly assigned to receive one of the interventions. As recommended by international guidelines for patients who receive drug-eluting stents, the PCI group also received anti-clotting therapies. A drug called abciximab was administered intravenously during the procedure, and clopidogrel was given orally for at least 12 months after the procedure, accompanied by aspirin for those who could tolerate it. Study participants were followed for at least two years.
"The advantages of CABG over PCI were striking in this trial and could change treatment recommendations for thousands of individuals with diabetes and heart disease," said Fuster.
FREEDOM was supported by NIH grants HL071988 and HL092989. Cordis, Johnson & Johnson, and Boston Scientific provided stents. Eli Lilly provided an unrestricted research grant for abciximab, and Sanofi-Aventis and Bristol Myers Squibb donated clopidogrel.
FREEDOM involved hundreds of investigators from more than 16 countries, with a clinical coordinating center at Mount Sinai School of Medicine and a data coordinating center at New England Research Institutes in Watertown, Mass.
For additional information or to arrange an interview with Yves Rosenberg, M.D., chief of the Atherothrombosis and Coronary Artery Disease Branch at the NHLBI, please contact the NHLBI Office of Communications at 301-496-4236 or firstname.lastname@example.org. To arrange an interview with Fuster, please contact Christie Corbett at the Mount Sinai School of Medicine at 212-241-9200 or email@example.com.
NHLBI Communications Office | EurekAlert!
New concept: Can Resuscitation be delayed?
31.03.2015 | Europäische Akademie Bozen - European Academy Bozen/Bolzano
For drivers with telescopic lenses, driving experience and training affect road test results
30.03.2015 | Wolters Kluwer Health
In an experiment at the Department of Energy's SLAC National Accelerator Laboratory, scientists precisely measured the temperature and structure of aluminum as...
The IPH presents a solution at HANNOVER MESSE 2015 to make ship traffic more reliable while decreasing the maintenance costs at the same time. In cooperation with project partners, the research institute from Hannover, Germany, has developed a sensor system which continuously monitors the condition of the marine gearbox, thus preventing breakdowns. Special feature: the monitoring system works wirelessly and energy-autonomously. The required electrical power is generated where it is needed – directly at the sensor.
As well as cars need to be certified regularly (in Germany by the TÜV – Technical Inspection Association), ships need to be inspected – if the powertrain stops...
When an earthquake hits, the faster first responders can get to an impacted area, the more likely infrastructure--and lives--can be saved.
The Atlantic overturning is one of Earth’s most important heat transport systems, pumping warm water northwards and cold water southwards. Also known as the Gulf Stream system, it is responsible for the mild climate in northwestern Europe.
Scientists now found evidence for a slowdown of the overturning – multiple lines of observation suggest that in recent decades, the current system has been...
Because they are regularly subjected to heavy vehicle traffic, emissions, moisture and salt, above- and underground parking garages, as well as bridges, frequently experience large areas of corrosion. Most inspection systems to date have only been capable of inspecting smaller surface areas.
From April 13 to April 17 at the Hannover Messe (hall 2, exhibit booth C16), engineers from the Fraunhofer Institute for Nondestructive Testing IZFP will be...
25.03.2015 | Event News
19.03.2015 | Event News
17.03.2015 | Event News
31.03.2015 | Life Sciences
31.03.2015 | Materials Sciences
31.03.2015 | Earth Sciences