FREEDOM study finds that CABG has better outcomes than PCI in diabetic patients with Coronary Disease

The FREEDOM study of 1900 patients over 5 years was funded by the National Heart,Lung and Blood Institute and found that for patients with diabetes and advanced coronary disease, coronary bypass surgery grafting (CABG) has a better outcome than percutaneous coronary intervention (with stents) (PCI).After five years, the CABG group had a lower combined rate of strokes, heart attacks, and deaths (18.7 percent) than the PCI group (26.6 percent). Strokes, which are a well-known risk of bypass surgery, occurred slightly more often in the CABG group (5.2 percent) than in the PCI group (2.4 percent). However, more people died from any cause in the PCI group (16.3 percent) than in the CABG group (10.9 percent). The survival advantage of CABG over PCI was consistent regardless of race, gender, number of blocked vessels, or disease severity.

The study was published in NEJM see "Strategies for Multivessel Revascularization in Patients with Diabetes"- Michael E. Farkouh, M.D for the FREEDOM Trial Investigators November 4, 2012 DOI: 10.1056/NEJMoa1211585.

A further study found that CABG is more cost effective than PCI as repeat revasculisations made stents more expensive.