MAR 23, 2015 11:09 AM PDT

Heart Bypass Surgery Outperforms New Generation Stents

WRITTEN BY: Judy O'Rourke
Despite the advent of a new generation of stents, patients with multiple narrowed arteries in the heart who received coronary artery bypass grafting fared better than those whose arteries were opened with balloon angioplasty and stents, according to a new study.

The findings echo past studies, which have shown patients with multiple narrowed arteries have better outcomes with coronary artery bypass grafting, also known as CABG or heart bypass surgery, than with angioplasty, also known as percutaneous coronary intervention or PCI, a less-invasive option in which a stent is inserted to hold the arteries open.

In the new study, patients receiving angioplasty with the new stents had a 47 percent higher risk of one of the outcomes identified as a primary endpoint in the study: death, heart attack, and subsequent procedure to clear blocked arteries, as compared to patients who received bypass. In bypass surgery, a vein or artery from elsewhere in the body is grafted onto a narrowed coronary artery to allow blood to flow to the heart more freely. The study reinforces current guidelines, which recommend bypass surgery for treating patients with substantial narrowing in multiple arteries, a condition known as multivessel coronary artery disease.

"Based on our data, CABG is still the preferred option for multivessel disease," says cardiologist Seung-Jung Park, MD, Asan Medical Center, Seoul, South Korea, and the study's lead author. "We had thought that previous trials may have been limited by their use of first-generation drug-eluting stents, but these results show CABG still leads to better outcomes."

The study, called the Bypass Surgery Versus Everolimus-Eluting Stent Implantation for Multivessel Coronary Artery Disease (BEST) trial, is one of only two randomized controlled trials to compare bypass to angioplasty since the introduction of everolimus-eluting stents, a new generation of drug-eluting stent. These stents emit medication to prevent blood clots and have been shown to be more effective at keeping arteries open. The trial's findings align with those from the previous study, called Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX).

The study was terminated earlier than planned, limiting its statistical power to detect differences in individual outcomes instead of only composite outcomes. The early termination was due to slow enrollment, thought to be a consequence of the rapid spread and increased appeal of a new angioplasty technique called fractional flow reserve during the later part of the study enrollment period.

The angioplasty procedures in the BEST and SYNTAX studies were guided by the medical imaging technique angiography.

Because it is a more invasive procedure, heart bypass is generally recommended only for patients with higher-risk narrowing in two or more arteries. Angioplasty is preferred for patients with lower-risk narrowing in one or two arteries.

[Source: American College of Cardiology]
About the Author
  • Judy O'Rourke worked as a newspaper reporter before becoming chief editor of Clinical Lab Products magazine. As a freelance writer today, she is interested in finding the story behind the latest developments in medicine and science, and in learning what lies ahead.
You May Also Like
JUN 26, 2020
Cardiology
Drug for Osteoporosis Linked to Increased Risk of Adverse Cardiovascular Events
JUN 26, 2020
Drug for Osteoporosis Linked to Increased Risk of Adverse Cardiovascular Events
In a recent study done by Jonas Bovijn, MBChB, MSc, DLSHTM, of the Big Data Institute at the University of Oxford’ ...
JUL 04, 2020
Cardiology
Discovering a New Signal Junction Controlling Pulmonary Arterial Hypertension
JUL 04, 2020
Discovering a New Signal Junction Controlling Pulmonary Arterial Hypertension
Pulmonary Arterial Hypertension (PAH) is a progressive and fatal disease characterized by the muscularization of blood c ...
AUG 06, 2020
Cardiology
Identifying a Prognostic Biomarker for Neurological Deterioration After a Stroke
AUG 06, 2020
Identifying a Prognostic Biomarker for Neurological Deterioration After a Stroke
Strokes are life-changing events that can cause a myriad of issues even after it is over. Plenty of tests, such as the n ...
SEP 08, 2020
Cardiology
Fixing Stem Cell Therapy for Heart Repair
SEP 08, 2020
Fixing Stem Cell Therapy for Heart Repair
Repairing the damage done by a heart attack has been of keen interest for decades. Some researchers think protecting the ...
SEP 12, 2020
Cardiology
Is Hyperuricemia an Indicator of Aortic Disease?
SEP 12, 2020
Is Hyperuricemia an Indicator of Aortic Disease?
Living in a culture of excess can have its benefits, but also its drawbacks. Diabetes is a common disease that is gettin ...
SEP 22, 2020
Cardiology
Mosquito-Borne Illnesses are Linked to Stroke
SEP 22, 2020
Mosquito-Borne Illnesses are Linked to Stroke
Mosquitoes are major disease vectors; they are considered the world's deadliest animal because they kill so many people.
Loading Comments...