In patients with stable ischemic heart disease (SIHD) and diabetes with multivessel coronary artery disease (CAD), coronary artery bypass grafting (CABG) may be superior to percutaneous coronary intervention (PCI), according to a real world, population-based evaluation of the FREEDOM trial presented Nov. 10 during AHA 2015 in Orlando.

The study looked at 4,819 procedures from patients undergoing coronary revascularization in British Columbia, Canada between 2007 and 2014. Results showed that the adjusted odds ratio for the primary endpoint – a composite of death, myocardial infarction (MI) and stroke – rates at 30-days was 0.61 (95 percent CI: 0.44, 0.85), and the corresponding hazard ratio for the 31-days to five-years post revascularization was 0.64 (95 percent CI: 0.54, 0.75), both in favor of CABG over PCI (p<0.01).

The investigators note that their results were consistent with those in the initial FREEDOM trial, as "death and MI and other serious complications were significantly lower in CABG patients." They conclude that moving forward, these results "require further evaluation and suggest a potential paradigm shift in the management of ACS patients with diabetes and multivessel CAD."

Keywords: AHA Annual Scientific Sessions, Coronary Artery Bypass, Coronary Disease, Diabetes Mellitus, Myocardial Infarction, Percutaneous Coronary Intervention, Stroke

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