Newer Drug-Eluting Stents Narrow Gap Between Cardiac Bypass and Stent Surgery Outcomes

Sripal Bangalore, MD, MHA Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA
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 are the main findings of the study?

Dr. Bangalore: We found that while CABG was associated with mortality benefit when compared with bare metal stents or first generation drug eluting stent, the gap between CABG and PCI was smaller and non significant when PCI was with newer generation DES. The same was true for repeat revascularization with the magnitude of benefit with CABG descending considerable from comparison with balloon angioplasty to newer generation DES.

Medical Research: Were any of the findings unexpected?

Dr. Bangalore: I wouldn’t call it unexpected but many of us had wondered about this question and it is good to see some hypothesis generating data.

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

Dr. Bangalore: We need clinical trials to prove our hypothesis. Up until that time, if a diabetic has disease treatable by either PCI or CABG the discussion w the patient should be about upfront risk of stroke with CABG vs late small increase of repeat revascularization with PCI.

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

Dr. Bangalore: The question about CABG or PCI with newer generation DES should be tested in future trials. That is the only way of testing the hypothesis we have generated.

Citation:

Outcomes With Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention for Patients With Diabetes Mellitus: Can Newer Generation Drug-Eluting Stents Bridge the Gap?
Circ Cardiovasc Interv.2014;CIRCINTERVENTIONS.114.001346published online before print June 17 2014, doi:10.1161/CIRCINTERVENTIONS.114.001346