Researchers at the Stanford University School of Medicine found that survival rates for bypass surgery and angioplasty were similar for patients with diabetes, dismissing earlier reports that angioplasty was linked to a considerably higher risk of death among diabetic patients.
Lead author Mark Hlatky, MD, professor of health research and policy and of cardiovascular medicine, assured that angioplasty and coronary bypass surgery were safe procedures for treating heart problems.
"It is reassuring that the long-term safety of these two procedures is roughly the same. Patients and their doctors can have a more informed discussion about which procedure should be done, based on other outcomes that are important to the patient," Hlatky said.
For treating patients with coronary artery disease, two medical interventions are available - bypass surgery and angioplasty. In bypass surgery, surgeons take a healthy blood vessel from another part of the body to create a detour around the blocked part of the coronary artery.
While in angioplasty, a tiny balloon is used to open a blocked artery; a mesh tube called a stent is inserted to hold open the artery after the procedure.
While angioplasty is typically used for those patients with single-vessel disease, bypass surgery is the preferred treatment for patients with blockages in the arteries.
However, Hlatky said that it's not always clear which is the best treatment choice, since both the treatments can be used in either of the cases.
In the study, data from 23 randomised clinical trials that compared treatments for patients with mid-range coronary disease was analysed.
Nearly 10,000 patients were examined; 4,944 patients were randomly assigned to surgery and 5,019 patients were randomly assigned to angioplasty.
Thorough analysis showed that the procedural survival rate for the two was almost the same - 98.2 percent for bypass surgery and 98.9 percent for angioplasty.
However, bypass surgery was associated with small but significantly greater risk of stroke within 30 days of the procedure.
With about 90 percent of patients living five years after either procedure, as was the risk of post-procedure heart attack, the long-term survival rates were comparable.
Within five years, about 12 percent of surgery patients and 10.9 percent of angioplasty patients had a heart attack.
Diabetic patients were specifically looked at in the study since diabetes is a key risk factor for coronary artery disease. No difference was found in survival rates between the two procedures while taking diabetes into consideration.
The study is published in Annals of Internal Medicine.