Newswise Mount Sinai School of Medicine researchers presented 89 abstracts and plenary sessions at the American Heart Associations (AHA) Scientific Sessions 2012, including the results of the FREEDOM trial, the first long-term study of its kind of individuals who have diabetes and advanced coronary artery disease (CAD).
Experts also presented research on education and medication adherence, efficacy of statin therapy in diabetes, and the use of 3D ultrasound to detect plaques in areas of the body other than the heart. The meeting took place November 4-7, 2012 in Los Angeles.
Individuals Who Have Diabetes and Advanced Coronary Artery Disease Have Significantly Better Outcomes with Bypass Surgery than Angioplasty: The FREEDOM Trial
In the highly anticipated FREEDOM Trial, an international team of researchers led by Valentin Fuster, MD, PhD, Director of Mount Sinai Heart, found that people with diabetes and CAD live longer, and are less likely to suffer a non-fatal heart attack, when treated with bypass surgery instead of angioplasty.
A total of 1,900 patients were enrolled from 2005 to 2010 at 140 international sites and randomized to undergo PCI/DES or CABG. All patients were prescribed standard medical therapy for coronary artery disease, which is aspirin and a blood thinner. At five years, 26.6 percent of patients in the PCI arm had a cardiovascular event, compared to 18.7 percent in the CABG arm.
Treating people with diabetes and heart disease presents unique challenges due to increased risk for death, heart attack, and stroke, said Dr. Fuster, Physician-in-Chief, The Mount Sinai Medical Center, Director of Mount Sinai Heart, and the Richard Gorlin, MD/Heart Research Foundation Professor, Mount Sinai School of Medicine. The FREEDOM trial is the first long-term, multi-site trial that seeks to firmly establish a standard of care for this high-risk population, which includes about 25 to 30 percent of patients with CAD undergoing coronary angiography.
At this years conference, Dr. Fuster was presented with the AHAs 2012 Research Achievement Award for his significant and enduring contributions to a broad spectrum of cardiovascular medicine, achievements that have accelerated progress toward conquering disease and enriching the human condition worldwide.
Aggressive Statin Regimen Less Effective in Reducing Blockages in Individuals with Diabetes: Results from the YELLOW Trial
In a sub-analysis of the YELLOW (The Reduction in Yellow Plaque by Aggressive Lipid-Lowering Therapy) trial, Mount Sinai researchers evaluated 87 patients treated with a statin or standard lipid therapy. Half of the 87 patients had diabetes. After seven weeks, plaque buildup was reduced more significantly in patients without diabetes compared to patients with diabetes.
These findings suggest that arterial plaque in people with diabetes is harder to treat and may require more intense and prolonged therapy to reduce the amount of atherosclerosis, said Annapoorna Kini, MD, Director of the Cardiac Catheterization Laboratory and Professor of Medicine at Mount Sinai and first author on the study. The YELLOW trial documents the beneficial effects of aggressive lipid lowering therapy in high-risk patients with coronary artery disease, but also indicates that more research is needed to identify the best treatment paradigm for people with diabetes and multivessel coronary artery disease.
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Mount Sinai Researchers Present Results of FREEDOM Trial at American Heart Association (AHA) Scientific Sessions