Stenting and angioplasties may be quicker and easier than bypasses, but they are less likely to lead to lasting results, the Los Angeles Times reports.
Compared with heart patients who underwent bypasses, those who received stents were 28 percent more likely to suffer a major event, such as a heart attack or stroke, according to a study of more than 1,800 patients that looked how patients fared three years after the procedures. The stented heart patients also were 46 percent more likely to need a repeat procedure to reopen arteries, and 22 percent more likely to die.
The new study, which was released at a Geneva meeting of the European Association for Cardio-Thoracic Surgery, is the first large trial to directly compare stenting and CABG, or coronary artery bypass grafts.
"Any time that you compare angioplasty and surgery, the longer you go, the better surgery looks," said Dr. Michael J. Mack, first vice president of the Society of Thoracic Surgeons and a co-author of the study.
Payers, patients and practitioners will need to factor the study findings into their own decisionmaking when weighing treatment options.
Surgeons have thought that over time, surgery is better for the most complex forms of heart disease, Dr. Richard Shemin, chief of cardiac and thoracic surgery at UCLA's Ronald Reagan Medical Center, told the Times. He was not involved in the study.
More than 1.3 million Americans now undergo angioplasty every year, compared with 448,000 who undergo bypass, according to the National Center for Health Statistics. The hospital stay for a coronary artery bypass graft, or CABG, can last five or six days, while a stay for insertion of a stent that releases an anti-clot formation drug is usually overnight.
To learn more:
- read the Los Angeles Times article