When it comes to choosing a stent or a scalpel to treat severe heart disease, this study finds that stents are as effective as bypass surgery, with less risk of stroke.
The study is published in this week’s The New England Journal of Medicine (NEJM).
Coronary artery bypass graft surgery or C.A.B.G is still the option of first choice for treating patients suffering from coronary artery disease. Debate has been ongoing as to whether using stents as scaffolds to keep arteries open was a good second option.
The disadvantage of stents appears to be that patients will require some additional treatment.
In this, one of the largest international multicenter trials, 1,800 patients at 85 medical centers in the U.S. and Europe were randomly assigned to undergo either C.A.B.G. or stenting.
All received follow-up monitoring including the need for repeat procedures, death, strokes or heart attack.
Among the stent patients, there was a 17.8 percent risk of suffering an adverse outcome. Among the C.A.B.G. patients, adverse events were 12.4 percent.
Both groups had a similar risk for heart attack and death, but the bypass surgery group was more likely to have a stroke with 2.2 percent suffering a stroke, compared to the stent group with 0.6 percent.
Dr. L. David Hillis, chairman of the department of medicine at the University of Texas Medical School in San Antonio, tells the New York Times.
“What they’re telling us is that these procedures are similar in many respects,” he added. “For individual patients, one is often better than the other. For a patient who can have either one, there are pluses or minuses to each one.”
The research was supported by Boston Scientific, maker of stents used in heart surgery. #