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Journalists:
please note that all presentations are embargoed until the
time of their actual presentation at the Late-Breaking Clinical
Trial (LBCT) sessions or ACC press conference, whichever comes
first. The date and time of each official presentation at
an LBCT session is provided at the end of each trial topic
description.
Highlights
from: Critical Analysis of Coronary Artery Bypass Surgery
TUESDAY,
MARCH 8, 2005
11:15
a.m.-12:00 p.m.
Bypass surgery
proves life-saving in high-risk patients
(ORLANDO, Fla.)—Studies being presented
at the American College of Cardiology’s 54th Annual
Scientific Session in Orlando, Fla., March 6-9, 2005, highlight
the benefits of coronary artery bypass grafting (CABG) surgery
in high-risk patients, while underscoring the harmful effects
of diabetes on long-term survival.
Among patients who have CABG surgery, those
with diabetes are significantly more likely to die over the
subsequent eight years than are patients without diabetes,
and heart disease is more likely to be the cause of death
(David R. Holmes, Jr., #862-3). Researchers examined the medical
records of more than 3,600 patients who participated in the
Bypass Angioplasty Revascularization Investigation (BARI).
They found that 32 percent of patients with diabetes died
during long-term follow-up, as compared to 14 percent of patients
without diabetes. Death was more often the result of cardiac
disease (51 percent vs. 43 percent), the largest difference
being in the rate of death from heart failure (16 percent
vs. 9 percent). Bypass surgery significantly reduced the risk
of sudden death in all patients. (Original presentation on
Tuesday, March 8, 2005, at 4:00 p.m.)
A separate study found that CABG surgery improves
long-term survival when compared to other treatment options
in diabetic patients who have several narrowed arteries in
the heart (Whady Hueb, #862-5). The Medicine Angioplasty or
Surgery Study (MASS) tracked the long-term survival of diabetic
and nondiabetic patients treated with CABG surgery, angioplasty
and stenting, or medical therapy. They found that the five-year
death rate was higher in diabetic patients regardless of the
treatment method. However, survival was significantly better
with CABG surgery among diabetic patient with multiple diseased
arteries in the heart. (Original presentation on Tuesday,
March 8, at 4:30 p.m.)
Bypass surgery may be a safer approach
than treatment with new drug-coated stents in patients with
several narrowed arteries in the heart (Ron Waksman, #862-4).
The study focused on patients who needed three or more stents
to prop open diseased coronary arteries. The stents were coated
with sirolimus, a drug that is slowly released into the artery
wall and prevents arterial renarrowing by interfering with
the growth of scar tissue. When compared with patients who
received only a single sirolimus-coated stent, patients in
the multiple-stent group were more likely to experience complications
during the procedure, and to suffer a heart attack or other
major cardiovascular illness within 30 days to six months.
The investigators concluded that CABG should be considered,
rather than stenting, in such patients. (Original presentation
on Tuesday, March 8, at 4:15 p.m.)
Moderator: TBD |
