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Stents Slightly Better Than Bypass for Blocked Left Coronary Artery
Date:1/29/2008

But experts question results of small Polish study

TUESDAY, Jan. 29 (HealthDay News) -- Implanting a stent in a clogged left main coronary artery appeared to give better short-term results than bypass surgery in a Polish study.

But American experts cast some doubt on the clinical value of the finding.

The study, led by cardiologists at the Medical University of Silesia, compared results of surgery versus stenting in 105 patients with serious blockages of the left main coronary artery, which is vital for heart function, because it feeds three other vessels.

There was a significant increase in the heart's blood-pumping ability over the next 12 months in the 52 participants who got the stent implants, but not in the 53 who underwent bypass surgery, said a report in the Feb. 5 issue of the Journal of the American College of Cardiology.

The incidence of major adverse events and the rate of survival was lower in the 30 days following the procedure for stent recipients than for patients who had surgery, the report said, "with a trend toward improved survival" in a two-year follow-up after stent implant.

"One of the limitations of this study is the very small number of patients," said Dr. Edward L. Hannan, assistant dean for research at the State University of New York at Albany, who recently reported at a meeting that surgery tended to be better than stenting for people with blockage of more than one heart artery.

And looking closely at the results, Hannan said he found "no significant difference" between the two methods in the incidence of major adverse events in the longer follow-up.

The Polish results differ from those of one he has done, which he is about to submit to a medical journal for publication, Hannan said. That study, which was not a controlled trial but looked at results reported in clinical practice, found an advantage for surgery over stenting.

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