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New data examine stents and bypass surgery in patients with 3VD and LMD
October 15, 2008Newly reported data presented at the 20th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF) from the SYNTAX clinical trial (SYNergy Between PCI With TAXUS and Cardiac Surgery) reveal similar safety and efficacy outcomes when the use of a drug-eluting stent is compared to heart bypass surgery in patients with left main disease.
Rates of major adverse cardiac and cerebrovascular events (MACCE) in patients with left main disease who received a stent were comparable with those who received bypass surgery (15.8% vs. 13.7% respectively). In addition, the overall safety measures of death, stroke and heart attack were similar: 7.0% for the patients that received a stent and 9.2% for the patients that received bypass surgery. Most importantly, patients who received stents rather than bypass surgery had fewer strokes at 1 year (0.3% vs. 2.7%, p=0.009), with similar rates of death (4.2% vs. 4.4 % respectively).
In patients with three-vessel disease, safety measures were comparable; however, the data reveal that patients who received angioplasty did show higher rates of revascularization and MACCE than those who received bypass surgery. In this group, the rate of revascularization in the stent group was higher (14.7% vs 5.4%, P<0.001). The overall rates of death, heart attack or stroke were similar in the 2 groups, however (7.9% vs 6.4%).
Data from the SYNTAX clinical trial also yielded a new tool to measure the complexity of coronary artery disease: The SYNTAX Score. The raw SYNTAX score is an effective predictor of major adverse coronary and cerebrovascular events, MACCE, according to the study. The trial data presented at TCT was used as part of calculating the score.
"The SYNTAX score is a new, innovative tool to describe the complexity of vasculature," said Patrick W. Serruys, MD, PhD, head of the Department of Interventional Cardiology at University Hospital Rotterdam, Netherlands and principal investigator of the study.
"SYNTAX has shown that TAXUS stents can be used safely rather than bypass surgery in the most complicated patients with coronary artery disease, those with left main and triple vessel disease." said Gregg W. Stone, MD, CRF Chairman, Professor of Medicine and the Director of Research and Education, Center for Interventional Vascular Therapy, NewYork-Presbyterian Hospital, Columbia University Medical Center. "The trade-off of 8 additional repeat revascularization procedures to prevent 2 strokes is more than acceptable. Moreover, the SYNTAX score will assist in assessing and determining whether stents or surgery are most appropriate for individual patients based on the severity of their disease."
Cardiovascular Research Foundation
Data from the SYNTAX clinical trial also yielded a new tool to measure the complexity of coronary artery disease: The SYNTAX Score. The raw SYNTAX score is an effective predictor of major adverse coronary and cerebrovascular events, MACCE, according to the study. The trial data presented at TCT was used as part of calculating the score.
"The SYNTAX score is a new, innovative tool to describe the complexity of vasculature," said Patrick W. Serruys, MD, PhD, head of the Department of Interventional Cardiology at University Hospital Rotterdam, Netherlands and principal investigator of the study.
"SYNTAX has shown that TAXUS stents can be used safely rather than bypass surgery in the most complicated patients with coronary artery disease, those with left main and triple vessel disease." said Gregg W. Stone, MD, CRF Chairman, Professor of Medicine and the Director of Research and Education, Center for Interventional Vascular Therapy, NewYork-Presbyterian Hospital, Columbia University Medical Center. "The trade-off of 8 additional repeat revascularization procedures to prevent 2 strokes is more than acceptable. Moreover, the SYNTAX score will assist in assessing and determining whether stents or surgery are most appropriate for individual patients based on the severity of their disease."
Cardiovascular Research Foundation
Bypass Surgery Current Events and Bypass Surgery News RSSDiabetes surgery summit consensus lays foundation for new field of medicine
A first-of-its-kind consensus statement on diabetes surgery is published online today in the Annals of Surgery.
Your Own Stem Cells Can Treat Heart Disease
The largest national stem cell study for heart disease showed the first evidence that transplanting a potent form of adult stem cells into the heart muscle of subjects with severe angina results in less pain and an improved ability to walk. The transplant subjects also experienced fewer deaths than those who didn't receive stem cells.
Heart study shows many suffer poor quality of life
The world's largest quality of life study of chronic angina patients attending general practice clinics has revealed that almost one in three experience frequent chest pain, which affects their daily life.
Oxygen treatment hastens memory loss in Alzheimer's mice
A 65-year-old women goes into the hospital for routine hip surgery. Six months later, she develops memory loss and is later diagnosed with Alzheimer's Disease.
Is there long-term brain damage after bypass surgery? More evidence puts the blame on heart disease
Brain scientists and cardiac surgeons at Johns Hopkins have evidence from 227 heart bypass surgery patients that long-term memory losses and cognitive problems they experience are due to the underlying coronary artery disease itself and not ill after-effects from having used a heart-lung machine.
High calcium level in arteries may signal serious heart attack risk
Researchers may be able to predict future severe cardiac events in patients with known, stable coronary artery disease (CAD) using coronary calcium scoring, according to a study published in the online edition of Radiology.
Probiotics help gastric-bypass patients lose weight more quickly, Stanford study shows
New research from the Stanford University School of Medicine and Stanford Hospital & Clinics suggests that the use of a dietary supplement after Roux-en-Y gastric bypass surgery can help obese patients to more quickly lose weight and to avoid deficiency of a critical B vitamin.
Bypass surgery has long-term benefits for children with Kawasaki disease
Coronary artery bypass surgery provides long-term benefits for children whose hearts and blood vessels are damaged by Kawasaki disease, Japanese researchers report in Circulation: Journal of the American Heart Association.
Roux-en-Y weight loss surgery raises kidney stone risk
The most popular type of gastric bypass surgery appears to nearly double the chance that a patient will develop kidney stones, despite earlier assumptions that it would not, Johns Hopkins doctors report in a new study.
Cardiac rehabilitation saves lives
Coronary heart disease (CHD) is the leading cause of death worldwide and a major driver of medical and economic costs, especially among older adults.
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