Patients with two or more diseased coronary arteries who underwent bypass surgery survived longer than patients who underwent the less-invasive procedure using stents, according to a study published in today's New England Journal of Medicine. The study also found that after three years, the rate of re-clogging of the arteries was considerably higher in the stent group.
Using New York's cardiac registries, the study identified 37,212 patients with multivessel disease who underwent bypass surgery and 22,102 patients with multivessel disease who underwent angioplasty between Jan. 1, 1997, and Dec. 31, 2000.
In an accompanying editorial, doctors at the Mayo Clinic in Rochester, Minn., said the high-powered study suggests that "things are not as clear-cut as originally thought," indicating that surgery may be superior in a larger group of patients. Still, advances in technologies in the past decade affecting both procedures, including drug-eluting stents and off-pump coronary bypass surgery are "a testimony to the constancy of change," they said.