AHA: Revascularization May Be Best for CAD Plus Diabetes

Improves blood flow more effectively than intensive medical management alone

TUESDAY, Nov. 16 (HealthDay News) -- Patients with coronary artery disease and diabetes who undergo revascularization appear to demonstrate improved blood flow compared to those who undergo aggressive medical management alone, according to a study presented at the American Heart Association's Scientific Sessions 2010, held from Nov. 13 to 17 in Chicago.

In a sub-study of the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial, Leslee J. Shaw, Ph.D., of the Emory University School of Medicine in Atlanta, and colleagues performed stress myocardial perfusion SPECT in 1,505 patients a year after they had been randomized to revascularization plus medical therapy or intensive medical therapy only.

The investigators found that 59 percent of revascularization patients had no inducible ischemia compared with 49 percent of patients who underwent medical management. The investigators also found that more ischemia was tied to a higher risk of death and major cardiovascular events. The median quantitative percent of the myocardium with stress perfusion abnormalities was 3 percent among revascularization patients compared with 9 percent of patients who underwent medical management.

"The benefits of lifestyle and medication take several months, so scanning after a year can provide a barometer of how effective your treatment has been at reducing ischemia," Shaw said in a statement. "Because nerves can be damaged by high blood sugar levels, people with diabetes don't always get chest pain when blood flow is reduced. This test can show reductions in blood flow whether or not you have symptoms, and a normal test can be very reassuring."

Several authors disclosed financial relationships with various pharmaceutical and medical device companies.

Abstract No. 12697
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