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Clinical Study
Heart Bypasses Beat Drug Stents in Study
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. 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 revascularisation (reopening of arteries),"
he said.
EH News Bureau
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