Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation
Search: search_blue_button Advanced Search
Circulation. 2005;112:1500-1515
doi: 10.1161/CIRCULATIONAHA.104.483339
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by King, S. B.
Right arrow Articles by Moses, J. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by King, S. B., III
Right arrow Articles by Moses, J. W.
Related Collections
Right arrow Restenosis
Right arrow Risk Factors
Right arrow Type 2 diabetes
Right arrow Catheter-based coronary and valvular interventions: other
Right arrow Catheter-based coronary interventions: stents
Right arrow CV surgery: coronary artery disease
Right arrow Chronic ischemic heart disease

(Circulation. 2005;112:1500-1515.)
© 2005 American Heart Association, Inc.


Controversies in Cardiovascular Medicine

Is surgery preferred for the diabetic with multivessel disease?

Surgery Is Preferred for the Diabetic With Multivessel Disease

Spencer B. King, III, MD

From the Fuqua Heart Center, Atlanta, Ga (S.B.K.), and Columbia University Medical Center, Center for Interventional Vascular Therapy, New York, NY (G.D., J.W.M.).


An extract of the first 250 words of the full text is provided, because this article has no abstract.
 


*    Introduction
 
When angioplasty was first introduced by Andreas Gruentzig in 1977, it was envisioned as a treatment for angina pectoris refractory to medical therapy but applicable to patients who might otherwise have undergone bypass surgery. Assessment of patients before the intervention included exercise stress testing documenting ischemia, and the lesions selected for treatment were those that could be attempted using the primitive balloon angioplasty equipment that was available at that time. As the equipment for percutaneous coronary interventions (PCIs) improved, the technique was expanded to encompass a larger population of patients who otherwise would have been referred for bypass surgery. By 1990, the frequency of coronary angioplasty had increased to equal that of coronary bypass surgery. By the end of the decade, almost twice as many percutaneous interventions were being performed as were coronary bypass surgical procedures.1 As angioplasty began to infringe on the domain of bypass surgery, there was a call for randomized control trials testing the comparative value of angioplasty in traditionally surgical applications. Andreas Gruentzig proposed such a trial when angioplasty had reached a degree of maturity 6 years after the first procedure was performed. National Heart, Lung, and Blood Institute (NHLBI) funding for the first comparison of bypass surgery and angioplasty was finally obtained, and the Emory Angioplasty versus Surgery Trial (EAST) was begun in 1987, 2 years after Gruentzig’s tragic death.2 A second multicenter randomized trial, the Bypass Angioplasty Revascularization Investigation (BARI), was also approved by the NHLBI and was begun 1 year after the initiation . . . [Full Text of this Article]

George Dangas, MD; Jeffrey W. Moses, MD

Spencer B. King, III, MD

George Dangas, MD; Jeffrey W. Moses, MD

Correspondence to Spencer B. King III, MD, JB and Dottie Fuqua Chair of Interventional Cardiology, The Fuqua Heart Center, 95 Collier Rd NW, Suite 2075, Atlanta, GA 30309 (e-mail sking@acri.com), or Jeffrey W. Moses, MD, Columbia University Medical Center, Center for Interventional Vascular Therapy, 161 Fort Washington Ave, IP, 5th Floor, New York, NY 10032 (e-mail jm2456@columbia.edu).




This article has been cited by other articles:


Home page
Eur Heart JHome page
U. Stenestrand, S. K. James, J. Lindback, O. Frobert, J. Carlsson, F. Schersten, T. Nilsson, B. Lagerqvist, and for the SCAAR/SWEDEHEART study group
Safety and efficacy of drug-eluting vs. bare metal stents in patients with diabetes mellitus: long-term of follow-up in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)
Eur. Heart J., November 10, 2009; (2009) ehp424v1.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
E. Mahmud, G. Bromberg-Marin, V. Palakodeti, L. Ang, D. Creanga, and A. N. DeMaria
Clinical efficacy of drug-eluting stents in diabetic patients: a meta-analysis.
J. Am. Coll. Cardiol., June 24, 2008; 51(25): 2385 - 2395.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
M. Thielmann, M. Neuhauser, S. Knipp, E. Kottenberg-Assenmacher, A. Marr, N. Pizanis, M. Hartmann, M. Kamler, P. Massoudy, and H. Jakob
Prognostic impact of previous percutaneous coronary intervention in patients with diabetes mellitus and triple-vessel disease undergoing coronary artery bypass surgery
J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 470 - 476.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
H. B. Barner
Status of percutaneous coronary intervention and coronary artery bypass.
Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 419 - 424.
[Abstract] [Full Text] [PDF]