Strategies for Multivessel Revascularization in Patients with Diabetes
نویسندگان
چکیده
Michael E. Farkouh, M.D., Michael Domanski, M.D., Lynn A. Sleeper, Sc.D., Flora S. Siami, M.P.H., George Dangas, M.D., Ph.D., Michael Mack, M.D., May Yang, M.P.H., David J. Cohen, M.D., Yves Rosenberg, M.D., M.P.H., Scott D. Solomon, M.D., Akshay S. Desai, M.D., M.P.H., Bernard J. Gersh, M.B., Ch.B., D.Phil., Elizabeth A. Magnuson, Sc.D., Alexandra Lansky, M.D., Robin Boineau, M.D., Jesse Weinberger, M.D., Krishnan Ramanathan, M.B., Ch.B., J. Eduardo Sousa, M.D., Ph.D., Jamie Rankin, M.D., Balram Bhargava, M.D., John Buse, M.D., Whady Hueb, M.D., Ph.D., Craig R. Smith, M.D., Victoria Muratov, M.D., M.P.H., Sameer Bansilal, M.D., Spencer King III, M.D., Michel Bertrand, M.D., and Valentin Fuster, M.D., Ph.D., for the FREEDOM Trial Investigators*
منابع مشابه
Coronary revascularization strategies in patients with diabetes and multivessel coronary artery disease: has the final chapter been written?
I n this issue of the Journal, Dangas et al. (1) report on an important subgroup of patients from the FREEDOM (Comparison of Two Treatments for Multivessel Coronary Artery Disease in Individuals With Diabetes) trial, a trial in which patients with type 2 diabetes mellitus (T2DM) and multivessel coronary disease were randomized to revascularization by percutaneous coronary intervention (PCI) using
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Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery b...
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BACKGROUND Percutaneous coronary intervention (PCI) is used with increasing frequency in patients with diabetes and multivessel disease. This study investigated evolving revascularization strategies in the State of Washington. METHODS The Clinical Outcomes Assessment Program captures all revascularization in the State of Washington and was used to compare diabetic patients with multivessel di...
متن کاملDebate: PCI or CABG for multivessel disease? Viewpoint: No clear winner in an unfair fight
The Arterial Revascularization Therapy Study (ARTS) and the Stent or Surgery (SoS) trial each randomized patients with multivessel disease to either stenting or bypass surgery. The ARTS showed no difference in mortality between the two strategies, other than in diabetic patients, who fared better with surgery. The SoS trial demonstrated increased mortality in the stent arm, a difference that wa...
متن کاملStrategies for multivessel revascularization in patients with diabetes: the FREEDOM trial.
BACKGROUND In some randomized trials comparing revascularization strategies for patients with diabetes, coronary-artery bypass grafting (CABG) has had a better outcome than percutaneous coronary intervention (PCI). We sought to discover whether aggressive medical therapy and the use of drug-eluting stents could alter the revascularization approach for patients with diabetes and multivessel coro...
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The choice of which coronary revascularization strategy is best for diabetic patients with multivessel coronary disease has always been complex. The presence of diabetes, especially insulin-requiring diabetes, has been associated with higher rates of acute and late-term adverse events for both PTCA1 and bypass surgery,2 making either approach seemingly suboptimal. The results of the Bypass Angi...
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