Bypass Best for Clogged Arteries

FRIDAY, Oct. 6 (HealthDay News) -- Coronary artery bypass surgery is more effective at extending the lives of patients with severe coronary artery disease than either angioplasty or heart medications, Duke University researchers report.

They analyzed the records of more than 18,000 patients who had at least one coronary artery that was more than 75 percent blocked (severe coronary artery disease) and who received bypass surgery, angioplasty or heart medications at Duke between 1986 and 2000.

The patients were divided into three groups, based on when they were treated: 1986-1990; 1991-1995; and 1996-2000. The final period is the most important, because that's when doctors first started inserting stents during angioplasty procedures, the study authors said. Stents are tiny wire-mesh tubes used to keep arteries open after blockages have been cleared.

Among patients treated between 1996 to 2000, those who received bypass surgery lived an average of 5.3 months longer than those treated by angioplasty, the study said.

The researchers also found that both bypass surgery and angioplasty were better than medicines alone at extending patients' lives.

The study was published in the October issue of the Annals of Thoracic Surgery.

The Duke team noted that up to 40 percent of patients with severe coronary artery disease are first treated with angioplasty or medications and not given the opportunity to receive bypass surgery, which is more expensive and more invasive.

"It may sound very appealing to patients with severe coronary artery disease to get a treatment that is less expensive and less invasive, but they many not be getting the same survival benefit as those patients receiving bypass surgery," lead investigator Dr. Peter Smith, chief of cardiothoracic surgery, said in a prepared statement.