20 Mar Both Stenting and Bypass Surgery Reasonable For 2+ Blocked Coronary Arteries

Posted at 18:20h in Author Interviews, Heart Disease, NEJM, NYU, UCSD by

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016.MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI
Director of Research, Cardiac Catheterization Laboratory,
Director, Cardiovascular Outcomes Group,
Associate Professor of Medicine,
New York University School of Medicine,
New York, NY 10016

Medical Research: What is the background for this study? What are the main findings?

Dr. Bangalore: Prior studies have shown a mortality benefit of bypass surgery over stenting. But these studies compared bypass surgery with older generation stents which are no longer used. We used data from the New York state registry of patients who underwent stenting or bypass surgery for 2 or more blockages of coronary arteries. With data from over 18,000 patients we found that there was no difference between stenting and bypass surgery for long term mortality. In addition we found that both procedures have trade offs. Bypass surgery has upfront risk of death and stroke whereas PCI has long term risk of needing a repeat procedure. In addition, in patients who underwent incomplete revascularization, there was increase in myocardial infarction with PCI.

Medical Research: What should clinicians and patients take away from your report?

Dr. Bangalore: Both PCI and bypass surgery are reasonable options for patients with 2 or more blockages of coronary arteries. The decision as to which one to choose should be based on weighing the upfront risk of death and stroke with bypass surgery versus the long term risk of needing a repeat procedure with PCI. Both the patients anatomy and preference should be taken into consideration.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Bangalore: We need large clinical trials that are well powered to address this question

Citation:

Presented at the 2015 ACC in San Diego March 2015 and published in NEJM:

Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Disease

March 16, 2015 Bangalore S., Guo Y., Samadashvili Z., et al.
10.1056/NEJMoa1412168

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MedicalResearch.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCA (2015). Both Stenting and Bypass Surgery Reasonable For 2+ Blocked Coronary Arteries 

Last Updated on June 10, 2015 by Marie Benz MD FAAD

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