|Stents, like Boston Scientific's Innova, may increase mortality rates for diabetics, compared to bypass surgery.--Courtesy of Boston Scientific|
As physicians around the globe voice concerns about over-stenting, a new study finds that diabetics with heart disease live longer if treated with coronary bypass surgery instead of stents.
In analysis published in Lancet, researchers at St. Michael's Hospital in Canada found that mortality rates are 30% lower for diabetics treated with bypass than those treated with stents. Diabetics represent about a quarter of all patients who undergo coronary procedures, according to the hospital, and more are being treated with drug-eluting stents billed to be just as effective while cutting out the need for major surgery.
This study represents a call to action for patients and physicians, cardiac surgeon and principal study author Subodh Verma said, as many diabetics could be increasing their odds of death in exchange for a shorter procedure.
"Although bypass surgery is more invasive than stenting, it is imperative that physicians and patients realize that long-term mortality reduction is best achieved with bypass surgery," Verma said in a statement. "Physicians must disclose this benefit to the patient to truly obtain informed consent."
The researchers pooled clinical data from more than 30 years of trials, looking at results from 3,612 diabetics with heart disease.
The concerns of over-stenting in diabetics echo industry-wide scrutiny on the prevalence of the procedure. Over the summer, the American Medical Association placed stenting in its list of the 5 most overused medical interventions, saying that roughly 10% of elective angioplasty performed nationwide are done with almost no chance of benefiting patients.
- read the St. Michael's statement
- check out the study abstract