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Heart bypasses beat drug stents in study

MUNICH
Mon Sep 1, 2008 5:04am EDT
A heart patient is prepared for a two-hour surgery at a hospital in a file photo. REUTERS/Chaiwat Subprasom

MUNICH (Reuters) - Patients with difficult-to-treat clogged arteries are better off getting bypass surgery rather than drug stents, according to results of a major clinical study on Monday.

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Both procedures proved equally safe but those patients receiving Boston Scientific's drug-coated Taxus stent were more likely to need a repeat procedure, researchers said.

The keenly awaited results of the so-called SYNTAX study by Dutch researchers were presented at the annual meeting of the European Society of Cardiology.

"Despite the advent of drug-eluting stents, surgery comes out a winner," Douglas Weaver, president of the American College of Cardiology, said after the results were presented.

The one-year study found that 17.8 percent of patients receiving stents -- tiny wire-mesh tubes used to prop open clogged heart arteries -- either died, suffered a heart attack, had a stroke or needed a repeat procedure.

The figure was 12.1 percent for those undergoing surgery and receiving coronary artery bypass grafting, known as CABG.

Stenting was introduced in the 1990s and allows doctors to treat patients by inserting a catheter into the groin, resulting in very quick recovery times. CABG requires open-heart surgery.

Doctors in Munich said the results would be studied carefully but might not lead to a dramatic change in practice since many of the patients in the Dutch study would probably have received surgery anyway in normal clinical practice.

A more favorable result for stenting, however, could have encouraged further use of stenting over CABG.

Keith Dawkins, Associate Chief Medical Officer at Boston Scientific, said he believed the study was reassuring for the use of stents, despite not achieving its goal.

"The primary endpoint was missed. But it wasn't missed because of safety concerns; it was missed due to revascularization (reopening of arteries)," he said.



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