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Diabetics, heart surgery, and stents

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Every year, 175,000 diabetics who have multiple blockages in their heart arteries elect to undergo either bypass surgery or angioplasty with stenting to relieve symptoms such as chest pain, shortness of breath, and fatigue. Most choose to have stents because the procedure is less invasive with a far shorter recuperation time, but bypass surgery turns out to be a much safer option, according to a study presented last week at the American Heart Association’s annual meeting in Los Angeles.

A multi-center research team — including scientists from the New England Research Institutes in Watertown and Brigham and Women’s Hospital — randomly assigned 1,900 heart patients with diabetes to either undergo bypass surgery or receive a drug-coated stent to open two or more blocked heart arteries. About 19 percent of those who underwent bypass surgery suffered a heart attack or stroke or died within five years compared with nearly 27 percent of those who received a drug-covered stent.

“These results were very striking,” said Dr. Valentin Fuster, the study’s senior author and director of the heart program at Mount Sinai Medical Center in New York. “In a majority of places in the world, these patients were receiving stents. This is going to change practice.”

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