Bypass better than stents for coronary disease
NEW YORK (Reuters Health) - For patients with several blockages in their coronary arteries, mortality rates are lower when they undergo bypass grafting rather than having the new generation of drug-eluting stents inserted, a study shows.
The results are published in this week's New England Journal of Medicine.
Dr. Edward L. Hannan, at the State University of New York, Rensselaer, and colleagues compared outcomes of nearly 10,000 patients with multiple coronary lesions who were treated with drug-eluting stents and almost 7500 similar patients who underwent coronary artery bypass grafting.
After making adjustments for the presence of other illnesses, the chances of dying within 18 months were approximately 25 percent lower with the coronary bypass operation than with insertion of drug-eluting stents. Estimated rates of heart attacks and the need for another procedure also favored bypass grafting rather than stenting.
The results "affirm that coronary artery bypass grafting remains the standard of care" for patients who require clearance of multiple coronary blockages, writes Dr. Joseph P. Carrozza, Jr., from Harvard Medical School, in an editorial. "However, stents may be an alternative for patients at high risk for surgical complications or when an informed patient chooses a less invasive option."
SOURCE: New England Journal of Medicine, January 24, 2008.