From staff reports
A recent study conducted by Medical Center researchers seems to contradict several highly-publicized clinical trials by suggesting that diabetics suffering from severe coronary artery disease show equally good results after receiving either angioplasty or coronary artery bypass surgery.
The findings were presented Tuesday at the annual scientific meeting of the American Heart Association.
In July, investigators in a previous study called the Bypass Angioplasty Revascularization Investigation reported in the New England Journal of Medicine that the five-year survival rate for diabetics treated with bypass surgery was 80.6 percent, while the survival rate for diabetics treated with angioplasty was only 65.5 percent. The National Heart Lung Blood Institute also recommended that diabetics with multi-vessel disease be treated with bypass surgery.
Following the publication of the BARI results, Medical Center researchers conducted their own studies by collecting and analyzing patient data relating to heart disease since 1969.
"After adjusting for such factors as age, gender and characteristics of their heart disease, we found that diabetics receiving either angioplasty or bypass had lower survival than non-diabetics receiving these interventions," said Dr. Greg Barsness, a fellow in the department of cardiology. "However, in contrast to the results seen in the BARI trial, the decrease in survival was similar among both angioplasty- and bypass-treated diabetics."
Eric Peterson, assistant professor of cardiology, patients receiving cardiac care may not always receive the best treatment.
"Sadly, hospitals now need to look at how every dollar is spent, and 'stenting' may become a luxury they can't afford," Peterson said.
Stents are mesh-like devices inserted into arteries to keep them open after clogs have been cleared by balloon angioplasty. Stenting's effectiveness has led to its considerable popularity-almost 170,000 stent procedures are expected to be performed this year.
Stenting's cost of about $13,000, however, is roughly $2,000 to $3,000 more than regular angioplasty.
Many cardiologists believe that stents are well worth their expense, especially since the devices' effectiveness reduces the rate of recurrent blockages in arteries, Peterson said.
Medicare and managed care companies, however, are not always willing to pay when hospitals perform the procedure, and as a result, hospitals are losing a great deal of money whenever a patient receives a stent, Peterson said,
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