Navigation Links
Death rates same for diabetes and heart disease patients receiving drug therapy or surgery
Date:6/7/2009

NEW ORLEANS, June 7 There is no difference in mortality among patients with type 2 diabetes and stable heart disease who received prompt bypass surgery or angioplasty compared to drug therapy alone, according to a landmark study focused exclusively on patients with both conditions. The study, which was led by investigators at the University of Pittsburgh Graduate School of Public Health, published in the June 11 issue of the New England Journal of Medicine and presented at the American Diabetes Association 69th Scientific Sessions, also found that while prompt bypass in patients with more severe heart disease did not lower mortality, it lowered their risk of subsequent major cardiac events.

"More than 20 million Americans suffer from type 2 diabetes and many of these people also have heart disease," said Sheryl F. Kelsey, Ph.D., principal investigator of the study and professor of epidemiology, University of Pittsburgh Graduate School of Public Health. "We began this study because we don't know how best to treat this deadly duo that is affecting more and more people at increasingly younger ages. Our results provide needed guidance about which approaches can best help these patients."

The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) study began recruiting patients in 2001. The results are based on 2,368 patients with both type 2 diabetes and stable heart disease who were under a physician's care to control their cholesterol and blood pressure. Patients were randomized to receive drug therapy plus undergo prompt revascularization to restore blood floweither angioplasty to open blocked arteries or bypass surgery―or to receive drug therapy alone. The investigators also looked at which of two diabetes drug treatment strategies resulted in better outcomes insulin-providing (increasing the amount of insulin) or insulin-sensitizing (lowering the body's resistance to its own insulin, such as metformin or rosiglitazone). The study was not a comparison between angioplasty and bypass surgery, but rather a comparison between a prompt procedure and medical therapy alone.

The results show that five-year survival rates did not differ significantly between the revascularization group (88.3 percent) and the drug therapy group (87.8 percent). In addition, there was no significant difference in survival between those who received insulin-providing drugs (87.9 percent) and those who received insulin-sensitizing drugs (88.2 percent). However, in the group that received bypass surgery, the rate of all major cardiovascular events (heart attacks, strokes and death) was significantly lower (22.4 percent) compared to those who received drug therapy alone (30.5 percent). This benefit appeared to be greatest in those who underwent bypass and received insulin-sensitizing drugs.

"We observed that patients with more severe heart disease did better over time when they received bypass early compared to those who received drug therapy alone," said Robert L. Frye, M.D., professor of cardiovascular medicine, Mayo Clinic College of Medicine, and BARI 2D study chairman. "Those who underwent bypass surgery seemed to do particularly well on insulin-sensitizing drugs. Although this result is preliminary because we did not set out to answer this question with our study design."

"Overall, the BARI 2D results reassure us that our current major drug treatments for diabetes are equally appropriate," said Saul Genuth, M.D., director of the diabetes management center of BARI 2D and professor of medicine, Case Western Reserve University. "They also indicate that when a patient with type 2 diabetes has more severe heart disease it may be better to do bypass surgery early than to wait and simply treat with medication. For patients with milder disease who are candidates for angioplasty, it is appropriate to treat with drug therapy first."


'/>"/>

Contact: Clare Collins
CollCX@upmc.edu
412-647-3555
University of Pittsburgh Schools of the Health Sciences
Source:Eurekalert

Related medicine news :

1. Penn study finds pro-death proteins required to regulate healthy immune function
2. Study, meta-analysis examine factors associated with death from heatstroke
3. Antioxidants show no clear benefit against cardiovascular events, death in high-risk women
4. Diabetes appears to increase risk of death for patients with acute coronary syndromes
5. Diet high in meat, fat and refined grains linked to risk for colon cancer recurrence, death
6. Longer ambulance journeys boost death risk for seriously ill patients
7. Stopping Statins After Stroke Doubles Death Risk
8. Oral Health a Matter of Life and Death for Seniors
9. Pop stars more than twice as likely to die an early death
10. Australian-led international study shows blood pressure drugs cut death rate in type 2 diabetes
11. Amid Improving Life Expectancy Rates, Risk of Premature Death is Still Significant for Americans, New Study Shows
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... ... May 04, 2016 , ... The RIDER Institute ... development of DRACO broad-spectrum antiviral therapeutics. DRACOs have proven effective against all 18 ... 3, 2016 at http://igg.me/at/EndTheVirus and runs for 60 days, we are ...
(Date:5/4/2016)... New York, N.Y. (PRWEB) , ... May 04, 2016 , ... ... Inaugural Spiritual Care Day to recognize chaplains for their valuable support to patients and ... observed annually on May 10. , To mark Spiritual Care Day, SCA has sent ...
(Date:5/4/2016)... ... , ... A new collaboration will give more researchers access to the largest ... analytics leader SAS will provide researchers worldwide with data management and analytics tools to ... , The DCRI and SAS share the goal of greater transparency and openness ...
(Date:5/4/2016)... ... May 04, 2016 , ... Washington Wellness Center today announced its ... Jersey residents. What started out as an idea to provide a holistic approach ... to healthcare. , Developed by Dr. David Swanekamp, Chiropractic Physician , the wellness ...
(Date:5/4/2016)... ... 2016 , ... Dr. Elyson and Dr. Assili, dentist in Northridge , ... tooth removal, a common dental procedure, is performed for many adolescents and young adults ... in risks of complications. By providing wisdom tooth removal surgery at their office, Dr. ...
Breaking Medicine News(10 mins):
(Date:5/4/2016)... DUBLIN , May 4, 2016 /PRNewswire/ ... the addition of the  "Global Multiple Myeloma ...  report to their offering.       ... Multiple Myeloma Market and Competitive Landscape Highlights ... pipeline products, Multiple Myeloma epidemiology, Multiple Myeloma ...
(Date:5/4/2016)... Research and Markets has ... Keratosis Market and Competitive Landscape Highlights - ...      (Logo: http://photos.prnewswire.com/prnh/20160330/349511LOGO ) , ... Highlights 2016, provides comprehensive insights into Actinic ... Keratosis market valuations and forecast, Actinic Keratosis ...
(Date:5/3/2016)... May 3, 2016 BioNovus Innovations LLC ... for Advancing Medical Innovation (IAMI) today announced a ... diagnostics and medical devices. An agreement ... rights to license, develop and commercialize medical innovations ... "This partnership represents a significant advance in ...
Breaking Medicine Technology: