FREEDOM
Future REvascularization Evaluation in patients with Diabetes mellitus: Optimal management of Multivessel disease
Paciente / Población Intervención / Exposición Comparación Desenlace
In 1,900 patients with diabetes and multivessel coronary disease, PCI with drug-eluting stents increased death, nonfatal MI, or nonfatal stroke compared with CABG.
N
1900
Diseño
Multicentre open-label RCT, superiority
Desenlace
Death from any cause, nonfatal MI, or nonfatal stroke
Relevancia
2
Resultado5-year primary event rate PCI 26.6% vs CABG 18.7% (P=0.005), favouring CABG, with lower all-cause death and MI but higher stroke (5.2% vs 2.4%).
Farkouh ME, et al. N Engl J Med. 2012;367(25):2375-84. 10.1056/NEJMoa1211585
Discusión y crítica
Used first-generation drug-eluting stents and the higher CABG stroke risk is an important trade-off. Definitive evidence that CABG is superior to PCI in diabetics with multivessel disease.