Bypass is Best for High-Risk Heart Patients

It tops angioplasty or stents when it comes to death rates for this group

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TUESDAY, April 27, 2004 (HealthDayNews) -- Five-year death rates were much lower for high-risk heart patients who had bypass surgery compared with those who had balloon angioplasty or stent procedures.

Cleveland Clinic researchers report the finding in the April 27 online issue of Circulation.

The study included people with multiple clogged coronary arteries and other health problems such as diabetes. It found the death rates after five years for 5,161 patients who had coronary artery bypass grafting (CABG) were nearly half that of 872 patients who had percutaneous coronary intervention (PCI), in which doctors use angioplasty or stenting to widen narrowed heart blood vessels.

"The sicker the patient, the more bypass surgery helped," study author Dr. Sorin J. Brener, an assistant professor of medicine and medical director of the Angiography Core Laboratory at the Cleveland Clinic Foundation, said in a prepared statement.

The one- and five-year unadjusted death rates were 4 percent and 14 percent for CABG and 5 percent and 16 percent for PCI. But, after propensity analysis adjustment, the researchers concluded PCI was associated with much higher death rates than CABG.

With propensity analysis adjustment, researchers factor in individual patient cardiovascular risk characteristics such as diabetes, smoking, high blood pressure and other elements -- along with procedural aspects -- into the survival rate comparison.

More information

The American Heart Association has more about bypass surgery.

SOURCE: American Heart Association, news release, April 26, 2004

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