Drug-Eluting Stents May Be Just As Good As Traditional Bypass Surgery, Study Finds, Giving New Options to Heart Patients

Treatment with drug-coated stents, those tiny metal tubes designed to prop open clogged heart arteries, may be just as effective and as safe as traditional open-heart bypass surgery for some patients with severe heart disease, new international research finds.

While coronary artery bypass graft surgery is still widely considered the best treatment for most cases of advanced heart disease, researchers who conducted one of the largest clinical trials on the topic found that for many people, stent therapy did not increase the risk of deadly heart attacks or strokes.

The study, published in the prestigious New England Journal of Medicine, expands conventional medical wisdom, which has long referred patients who might benefit from drug-eluting stent therapy for open-heart surgery. Now, physicians might have another viable option for treating advanced heart disease in patients who either do not want to or for some other reason are not good candidates for open-heart procedures.

Research Conducted in U.S. and Europe

Researchers from universities around the world conducted the largest international clinical trials designed to test the viability of bypass surgery compared to treatment with drug-eluting stents. About 1,800 people treated in 85 medical centers in the United States and Europe for severe, untreated, three-vessel heart disease or left main coronary artery disease took part. All the subjects were men and treated for one year.

Patients in the study were randomly assigned to either undergo open-heart bypass surgery or stent therapy then followed to see how they did. Adverse reactions, such as deaths, heart attacks, and strokes, were noted.

The result was that while stent patients had a higher rate of adverse outcomes than open-heart patients, 17.8 percent compared to 12.4 percent, the two groups had similar risks for deadly heart attacks and stent patients were less likely to suffer strokes, the researchers said.

However, stent patients were more than twice as likely to require repeat procedures, such as to place additional stents, compared to open-heart patients. About 13.5 percent of stent patients required revascularization procedures, compared to just 5.9 percent of bypass patients requiring repeat procedures.

Open-Heart Surgery Still Preferred for Most Patients

Bypass surgery is still the preferred treatment for heart disease in about two-thirds of cases, the researchers said, but physicians called positive results in stent patients an encouraging sign for the treatment of a leading killer of Americans.

Another Tool in a Doctor’s Belt

The millions of heart-disease patients in the United States should be encouraged by the research showing that stent therapy, in many cases, may be just as good as traditional open-heart bypass surgery. Many heart disease sufferers are understandably nervous about having major surgery, and while bypass surgery is still the primary and most effective treatment in the majority of heart disease cases, giving surgeons and treating physicians another tool to use in battling the condition can only be seen as a positive step for medical science.

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