How to Decide: Heart Bypass or Stents?

Tuesday, 23 Apr 2013 07:01 AM


  Comment  |
   Contact Us  |
|  A   A  
  Copy Shortlink
The average person with multiple diseased arteries in the heart does slightly better following coronary artery bypass surgery than after having stents inserted, a new study suggests, but the optimal procedure varies by patient.
Researchers found slightly more heart patients survived at least five years after bypass surgery - 74 percent, versus 72 percent of those who had a stenting procedure, known as angioplasty.
However, people who had no diabetes or heart failure and were non-smokers tended to have better outcomes with angioplasty than with more invasive surgery, the study team reported Monday in the Annals of Internal Medicine.
"It's good to say, ‘On average people do better with this drug or this procedure,'" said Dr. Mark Hlatky, a health policy and cardiovascular medicine researcher at Stanford University in California. "But if we could only target the people who would get the most benefit, we'd probably make better decisions and maybe save money," he told Reuters Health.
For their study, Hlatky and his colleagues tracked the records of 105,156 people on Medicare, the government health insurance program for the elderly, who had bypass surgery or received stents between 1992 and 2008. Patients from each treatment group were matched by age and the year they had their procedure.
The researchers calculated the average patient lived 19 days longer after bypass surgery than stenting. People with diabetes, heart failure and peripheral artery disease, as well as those who smoked, were especially likely to benefit from bypass surgery.
But the rest of heart patients - as many as 41 percent - were predicted to do better after angioplasty, they found.
Bypass surgery involves grafting a healthy blood vessel around a blocked one, so blood "bypasses" the unhealthy vessel. For a stent procedure, a small mesh tube is inserted into the blood vessel after it's opened with a balloon-tipped catheter.
The results are consistent with other recent research suggesting people with diabetes and multiple clogged arteries fare better after undergoing bypass surgery than after receiving drug-coated stents.
"The first question is whether you need something done at all, (or) whether drugs alone are enough," Hlatky said. "The second questions is, once you think you do need to go ahead and drug therapy is not enough - either because symptoms are too bad or the patient is high-risk - then you can decide between bypass surgery and angioplasty."
For people who have only one clogged vessel, angioplasty is typically fine, Hlatky said.
"On the other end if there's very, very severe coronary disease in lots of places, most of the time patients go straight to surgery," he added.
It's in the middle where patients and doctors can use studies like this one to make more informed decisions about what treatment might be best for them, Hlatky said.
According to the Healthcare Blue Book, bypass surgery runs for about $64,000, including the hospital stay. Because angioplasty requires fewer days in the hospital, it typically costs less than half that.

© 2014 Thomson/Reuters. All rights reserved.

  Comment  |
   Contact Us  |
  Copy Shortlink
Around the Web
Join the Newsmax Community
Please review Community Guidelines before posting a comment.
>> Register to share your comments with the community.
>> Login if you are already a member.
blog comments powered by Disqus
Zip Code:
Privacy: We never share your email.
Hot Topics
Follow Newsmax
Like us
on Facebook
Follow us
on Twitter
Add us
on Google Plus
Around the Web
Top Stories
You May Also Like

Selenium Found to Boost Cancer Treatment

Tuesday, 25 Nov 2014 16:50 PM

Selenium - naturally found in such foods as garlic and- may help in the fight against certain types of cancer, a new stu . . .

Football Players Suffer Brain Damage From Even Mild Impacts: Study

Tuesday, 25 Nov 2014 16:43 PM

Researchers using new, enhanced imaging can now identify brain damage that occurs in professional football players follo . . .

Healthy Gut Bacteria Prevent Metabolic Syndrome: Study

Tuesday, 25 Nov 2014 16:35 PM

Promoting healthy gut bacteria, also known as "microbiota," can help treat or prevent metabolic syndrome, a new study f . . .

Most Commented

Newsmax, Moneynews, Newsmax Health, and Independent. American. are registered trademarks of Newsmax Media, Inc. Newsmax TV, and Newsmax World are trademarks of Newsmax Media, Inc.

America's News Page
©  Newsmax Media, Inc.
All Rights Reserved