An international study in this week's issue of The Lancet highlights how patients given bypass surgery for blocked or narrowed coronary arteries are less likely to require further intervention than patients given stent-assisted balloon angioplasty. The study also reported an apparent survival benefit for patients given bypass surgery over those given angioplasty.

Results of previous trials comparing coronary angioplasty with coronary artery bypass grafting (CABG) suggest that rates of death or heart attack do not differ between treatment strategies. However, coronary angioplasty is associated with an increased likelihood of the need for additional revascularisation (another, unplanned repeat procedure). The use of stents in addition to balloon angioplasty should reduce the need for additional revascularisation; the aim of the Stent or Surgery (SoS) trial, led by Rodney Stables from the Cardiothoracic Centre, Liverpool, UK, was to compare the effect of stent-assisted coronary angioplasty with CABG.

1000 patients with coronary artery disease from 53 centres in Europe and Canada were randomly assigned to treatment with stent-assisted angioplasty or CABG. After an average two-year follow-up, around 20% of patients given stenting required additional revascularisation compared with only 6% of patients given CABG. Overall, there was a reduction in subsequent heart attack among patients given angioplasty (5%) than those given CABG (8%). There were fewer deaths among patients given CABG (2%) than those given angioplasty (5%).

Rodney Stables comments: "The use of coronary stents has reduced the need for repeat revascularisation when compared with previous studies that used balloon angioplasty, though the rate remains significantly higher that in patients managed with CABG. The apparent reduction in mortality with CABG requires further investigation."

In an accompanying Commentary (p 961), William O'Neill and Cindy Grines from William Beaumon
'"/>

Contact: Richard Lane
richard.lane@lancet.com
44-207-424-4949
Lancet
26-Sep-2002

Page: 1 2
Related medicine news :

1. Stents and going with the flow
2. Stents combined with clot-busting drugs effective in limiting impact of deadly form of stroke
3. Preliminary US study findings support excellent results with CYPHER Sirolimus-eluting Stent
4. American Heart Association Comment: Nonsurgical Reconstruction Of Thoracic Aortic Dissection By Stent-Graft Placement
5. Cordis Cardiology Introduces The MINI Crown Stent
6. Stent Procedures May Be Unnecessary In Some Heart Cases
7. Routine Use Of Coronary Stents Found To Yield Better Outcomes, Be More Cost-Effective
8. Stents Work Well, But Are Costly: Will Hospitals Continue To Use Them?
9. Health care report cards may increase racial/ethnic disparities in bypass operations
10. Gender a factor in who gets bypass surgery
11. Gastric bypass works for GERD and obesity in patients with prior surgery, says Pitt study