Why is heart bypass surgery a good choice 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.

Study researcher Rephael Mohr, MD, of Israel's Tel Aviv Sourasky Medical Center, explained that coronary arterial blood vessels in diabetic patients are smaller, which increases the risk of new blockages of the blood vessels after treatment with stents.

“We recommend the surgical option to our patients with diabetes and significant coronary artery disease because bypass will promise them longer survival with a lower chance for return of angina or additional procedures to address blockage,” said Dr. Mohr. “They will also have a reduced chance of heart attack and cardiac-related mortality.”

Peter K. Smith, MD, division chief of cardiovascular and thoracic surgery at Duke University Medicine in Durham, NC, said awareness of this study is very important.

“This study indicates that, in general, bypass surgery is preferred for patients with diabetes,” said Dr. Smith, who was not involved with the research. “The durability of bypass grafts compared to DES is especially important because diabetic patients more frequently have all of their coronary arteries blocked, the disease in the arteries is more serious in nature, and they frequently have had a heart attack in the past.”