Researchers say heart bypass a better option than drug-eluting stents

Major clinical research has found that for many patients with clogged arteries, bypass surgery is a better option than drug-eluting stents.

The Dutch researchers say for patients with difficult-to-treat clogged arteries, surgery was best, as those given a drug-coated stent were more likely to need a repeat procedure.

Patients typically need at least a month to fully recover from open-heart surgery which can be a five-hour long operation under general anesthesia, whereas angioplasty patients are often up and walking around after three days.

The results of the 'SYNTAX' study comparing Boston Scientific's drug-coated Taxus stents with bypass surgery have been eagerly awaited.

The researchers found after a 12 month study of more than 3,000 patients in Europe and the United States, that 17.8 percent of patients receiving stents 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.

The study excluded patients who had acute heart attacks and included those who had single and multiple vessel blockages.

Stents are tiny wire-mesh tubes used to prop open clogged heart arteries and were first introduced in the 1990s and the procedure, which allows doctors to treat patients by inserting a catheter into the groin, means a very quick recovery time, whereas CABG requires open-heart surgery.

Research in 2006 revealed that patients with the drug-coated stents were more likely to develop potentially fatal blood clots months and even years after they were implanted and in January this year more research found that bypass surgery was still the best option for heart patients with more than one clogged artery.

Some experts say the results 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.

But a more favorable result for stenting could have encouraged further use of stenting over CABG; Boston Scientific say the study was reassuring for the use of stents, despite not achieving its goal.

Experts warn that more data is still needed about the pros and cons of bypass surgery versus angioplasties, and that patients need to be tracked for at least five years.

The researchers presented the findings at the annual meeting of the European Society of Cardiology where Douglas Weaver, President of the American College of Cardiology, commented that surgery has 'come out a winner'.

The study was funded by Boston Scientific.