Evidence map›Paper›PMID 30428398›Full record

Trial reportJournal of the American College of Cardiology2019

Long-Term Survival Following Multivessel Revascularization in Patients With Diabetes: The FREEDOM Follow-On Study.

Michael E Farkouh, Michael Domanski, George D Dangas, Lucas C Godoy, Michael J Mack, Flora S Siami, Taye H Hamza, Binita Shah, Giulio G Stefanini, Mandeep S Sidhu and 8 more

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 109 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
109citing papers in PubMed, 9 pooled it
27.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00086450 phase3unknown statusnot on this map

Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM)

TypeinterventionalSponsorValentin FusterRan2004 to 2018Enrolled1,900ConditionsCardiovascular Diseases, Coronary Disease, Diabetes Mellitus, Heart DiseasesArmsCoronary Artery Bypass Graft, Percutaneous Coronary Intervention
NCT06995586 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The Synergistic Action of Vitamins and Dietary Supplements in Patients With Coronary Artery Bypass Grafting for Improving the Quality of Healthcare Delivery.

TypeinterventionalSponsorNicosia General HospitalRan2026 to 2028Enrolled108ConditionsCardio-pulmonary Bypass, Cardiovascular Diseases, Omega-3 Polyunsaturated Fatty Acids, Omega-3 SupplementationArmsVitamin C, Omega 3 PUFA (EPO/DHA), Lignin, Lactulose
3 · Its place in the literature

Who cites it

109 citing papers in PubMed, 9 syntheses or guidelines pooled it, 255 citations in OpenAlex.

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  19. Association Between Interventional Cardiologist Practice Characteristics, Coronary Artery Bypass Grafting Use, and Clinical Outcomes.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
    Observational
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49 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 14 institutions in 7 countries.

Michael E FarkouhPeter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address: Michael.Farkouh@uhn.ca.
Michael DomanskiUniversity of Maryland School of Medicine, Baltimore, Maryland.
George D DangasZena and Michael Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Lucas C GodoyPeter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada; Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Michael J MackBaylor Scott & White Health, Dallas, Texas.
Flora S SiamiNew England Research Institutes, Watertown, Massachusetts.
Taye H HamzaNew England Research Institutes, Watertown, Massachusetts.
Binita ShahVA New York Harbor Healthcare System, New York University School of Medicine, New York, New York.
Giulio G StefaniniHumanitas Research Hospital, Milan, Italy.
Mandeep S SidhuAlbany Medical Center, Albany, New York.
Jean-François TanguayDivision of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Quebec, Canada.
Krishnan RamanathanUniversity of British Columbia, Vancouver, British Columbia, Canada.
Samin K SharmaZena and Michael Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
John FrenchCardiology Department, Liverpool Hospital, Sydney, New South Wales, Australia.
Whady HuebInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
David J CohenSaint-Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri.
Valentin FusterZena and Michael Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain. Electronic address: valentin.fuster@mountsinai.org.
FREEDOM Follow-On Study Investigators
Icahn School of Medicine at Mount Sinai · USMontreal Heart Institute · CAUniversity of British Columbia · CAHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRLiverpool Hospital · AUNew England Research Institutes · USUniversity of Toronto · CAVA NY Harbor Healthcare System · USAlbany Medical Center Hospital · USBaylor Scott & White Health · USIRCCS Humanitas Research Hospital · ITSaint Luke's Hospital · USSpanish National Centre for Cardiovascular Research · ESUniversity of Maryland, Baltimore · US

Funding

Anti-inflammatory therapy during percutaneous coronary interventionIK2CX001074 · VA · VA MEDICAL CENTER · PI SHAH, BINITA · 2016 to 2021
–
CSRD VA IK2 CX001074
6 · The paper itself

Abstract

backgroundThe FREEDOM (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) trial demonstrated that for patients with diabetes mellitus (DM) and multivessel coronary disease (MVD), coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention with drug-eluting stents (PCI-DES) in reducing the rate of major adverse cardiovascular and cerebrovascular events after a median follow-up of 3.8 years. It is not known, however, whether CABG confers a survival benefit after an extended follow-up period.

objectivesThe purpose of this study was to evaluate the long-term survival of DM patients with MVD undergoing coronary revascularization in the FREEDOM trial.

methodsThe FREEDOM trial randomized 1,900 patients with DM and MVD to undergo either PCI with sirolimus-eluting or paclitaxel-eluting stents or CABG on a background of optimal medical therapy. After completion of the trial, enrolling centers and patients were invited to participate in the FREEDOM Follow-On study. Survival was evaluated using Kaplan-Meier analysis, and Cox proportional hazards models were used for subgroup and multivariate analyses.

resultsA total of 25 centers (of 140 original centers) agreed to participate in the FREEDOM Follow-On study and contributed a total of 943 patients (49.6% of the original cohort) with a median follow-up of 7.5 years (range 0 to 13.2 years). Of the 1,900 patients, there were 314 deaths during the entire follow-up period (204 deaths in the original trial and 110 deaths in the FREEDOM Follow-On). The all-cause mortality rate was significantly higher in the PCI-DES group than in the CABG group (24.3% [159 deaths] vs. 18.3% [112 deaths]; hazard ratio: 1.36; 95% confidence interval: 1.07 to 1.74; p = 0.01). Of the 943 patients with extended follow-up, the all-cause mortality rate was 23.7% (99 deaths) in the PCI-DES group and 18.7% (72 deaths) in the CABG group (hazard ratio: 1.32; 95% confidence interval: 0.97 to 1.78; p = 0.076).

conclusionsIn patients with DM and MVD, coronary revascularization with CABG leads to lower all-cause mortality than with PCI-DES in long-term follow-up. (Comparison of Two Treatments for Multivessel Coronary Artery Disease in Individuals With Diabetes [FREEDOM]; NCT00086450).

Indexed as

Coronary Artery BypassPercutaneous Coronary InterventionAgedCoronary Artery DiseaseDiabetic AngiopathiesDrug-Eluting StentsFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedProportional Hazards ModelsSurvival RateTreatment Outcomecoronary artery diseasecoronary revascularizationdiabetes

Identifiers

PMID30428398
PMCPMC6839829
OpenAlexW2899849495

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.