BARI 2D Substudy Finds Revascularization Superior in Quality-of-Life Benefits

November 19, 2009—The Society for Cardiovascular Angiography and Interventions (SCAI) issued an advocacy update following the presentation of substudies of the BARI 2D (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics) trial that were presented at American Heart Association 2009 Scientific Sessions. The presentation included an assessment of quality of life and economic outcomes in type 2 diabetics with coronary artery disease (CAD) undergoing revascularization versus medical therapy alone. The study by Bernard R. Chaitman, MD, et al, was published online in Circulation.

According to SCAI, these substudies provide the first major quality-of-life data for diabetes patients undergoing revascularization. Diabetes patients with greater ischemic burden in the revascularization stratum of the study, either coronary artery bypass grafting or percutaneous coronary intervention, reported greater quality-of-life improvement in physical activity, energy, and self-rated health—statistically significant differences compared to patients initially treated with medication alone. Additionally, while the upfront revascularization costs were higher than for medical therapy alone in patients with moderate to severe CAD, these patients experienced a lower risk of mortality or future myocardial infarction when revascularization was coupled with insulin sensitizers.

These results add to the body of knowledge and scientific evidence that diabetics with moderate to severe ischemic burden may benefit from revascularization in that they demonstrate fewer myocardial infarctions and improved quality of life. While future studies will continue to test the efficacy and cost effectiveness of revascularization therapies, the BARI 2D substudy data confirm the benefits of revascularization to effectively manage patients with both diabetes and moderate to severe CAD, the SCAI stated.