How safe is heart bypass surgery for people with diabetes?

People with diabetes mellitus who undergo heart bypass surgery for multiple blocked arteries have a significantly better five-year survival rate than diabetic patients who undergo angioplasty with drug-eluting stents (DES), according to a study published in The Annals of Thoracic Surgery.

The study, by researchers at Israel’s Tel Aviv Sourasky Medical Center, is the first comparative effectiveness demonstration of coronary artery bypass grafting (CABG) surgery using both internal thoracic arteries versus percutaneous coronary intervention (PCI) with DES in patients with diabetes.

Yaron Moshkovitz, MD, Rephael Mohr, MD, and colleagues reviewed 5-year outcomes for 226 patients who underwent bilateral internal thoracic artery (BITA) grafting with outcomes for 271 patients who underwent PCI with DES. They found that BITA patients had a 13% greater survival rate, as well as a lower risk for non-fatal heart attacks, recurrent chest pain, and future re-interventions. Additionally, they found that the more stents that were used, the greater the risk of a major cardiovascular event.

“The long-term benefit of BITA bypass graft surgery is probably related to the protection provided by CABG conduits that bypass the blockages and protect against future blockages,” said Dr. Mohr. “Protection from recurrent coronary events due to disease progression cannot be achieved by the stents placed in the coronary arteries during heart catheterization.”