Studies question heart bypass, angioplasty method

[tjscott0]

Studies question heart bypass, angioplasty method - Yahoo! News

The bypass study's surprising result is "a blockbuster," McNulty said. The operation did not improve survival for heart failure patients who already were taking medicines to control risks like high cholesterol and high blood pressure.


Clogged arteries cause about two-thirds of the 6 million cases of heart failure in the United States. The heart isn't getting enough blood and enlarges as it grows weaker from working too hard. Doctors often advise bypass to improve blood flow, but the new study calls that into question.
"Even if surgery is better, it's not better by much," said Dr. Byron Lee, a heart specialist at UCSF.


The study involved 1,200 heart failure patients in 22 countries, mostly men around 60 years old. Most had suffered a heart attack in the past. All were taking medicines they should for heart risks, and half were assigned to also get bypass surgery.


Doctors assumed bypass would cut deaths by 25 percent. But after nearly five years, about the same number in each group had died, said study leader Dr. Eric Velazquez of Duke University Medical Center.

For the first two years, there were more deaths among those given surgery versus the others.

"If you don't have an expectation to outlive that two-year window," surgery is not a good idea, Velazquez said.

 

[Rich_by_the_Bay]

I have not read the paper, but be aware that it refers to bypass for congestive heart failure, not for typical coronary disease (angina, heart attacks, severe big artery blockage being the usual symptoms and reasons for coronary artery bypass grafts).

Diffusely clogged arteries can cause heart failure but is a much smaller group than those having bypass for typical coronary disease. Many were not convinced that it was useful in the CHF group, and the study you describe seems to support that point of view.

 

[tjscott0]

MMS: Error

http://www.nejm.org/doi/full/10.1056/NEJMoa1100356?query=featured_home

Link to New England Journal of Medicine article above.