Stents, coronary bypass show equal benefit: study
By Gene Emery
BOSTON (Reuters) - Stents kept people alive just as effectively as heart bypass surgery, but the stents were nearly six times more likely to clog over time, Korean researchers reported on Monday.
Dr. Ki Bae Seung of the Catholic University of Korea in Seoul and colleagues found that after three years, the risk of death, heart attack or stroke was 9.2 percent for 542 bypass recipients versus 9.3 percent for a matched group of stent recipients.
Coronary-artery bypass grafting, known as CABG, involves stitching in a vein or artery to go around a blocked artery. Stents are mesh tubes used to prop open a blocked artery.
Seung's team used the MAIN-COMPARE registry from 12 major heart treatment centers in South Korea for the study, released in the New England Journal of Medicine to coincide with a meeting in Chicago of the American College of Cardiology.
They found recipients of bare-metal stents were 5.9 times more likely to need further surgery to reopen the artery than patients who got bypass surgery.
The researchers also compared the outcomes for people who receive drug-releasing stents and older stents, finding a slight increase in death and other problems with the drug-eluting stents. However the difference was not dramatic enough to be statistically significant.
"In our study, despite the lower rates of repeat revascularization with drug-eluting stents than with bare-metal stents, CABG was still more effective than drug-eluting stents in reducing the need for target-vessel revascularization," the researchers wrote.
All the volunteers had blockages in their left main coronary artery, the worst location.
In a commentary in the Journal, Dr. Robert Jones of Duke University Medical Center in Durham, North Carolina said the MAIN-COMPARE study does not prove that the surgery and stenting are equal.
That, he said, would require a large long-term randomized study.
(Editing by Maggie Fox)