FREEDOM: Insulin Status Affects Revascularization Outcomes in Diabetic Patients
San Francisco, CA—An analysis of the FREEDOM trial indicated higher rates of MACE at 5 years after revascularization among patients with diabetes who were treated with insulin compared with those who did not receive insulin therapy, according to a presentation at TCT 2013.
“In patients with diabetes and multivessel CAD, there was more MACE in patients treated with insulin than in those not treated with insulin, but the differences in clinical outcomes between CABG and DES were maintained regardless of the presence or absence of insulin treatment,” Dangas said.
Patients treated with insulin were more likely to be female (38.7% vs. 23.5%), heavier (BMI, 30.5 g/m2 vs. 29.3 g/m2), have a longer duration of diabetes (15.1 years vs. 7.7 years), have an elevated HbA1c (8.5% vs. 7.5%), and have a history of hypertension (87.5% vs. 83.2%), congestive HF (32.1% vs. 24.3%) and ACS (35.1% vs. 28.6%).
Data from the main FREEDOM trial, published in The New England Journal of Medicine last year, demonstrated that CABG was superior to PCI for rates of death and MI and was associated with a higher risk for stroke.
Dangas reports no relevant conflicts of interest.