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SCAI: SYNTAX Data Show PCI Is a Good Option for Patients With Complex Coronary Artery Disease
Date:9/1/2008

-eluting stents vs. bypass surgery in patients with the most complex coronary artery disease -- left main stenosis and three-vessel disease. Today's presentation revealed findings for the primary endpoint, focusing on the safety and effectiveness of the two therapies and whether either group experienced more heart attack, stroke, or death, or was more likely to require repeat revascularization procedures (either a second PCI or bypass surgery) by the end of the first year.

In its head-to-head comparison of PCI vs. bypass surgery, SYNTAX found no statistically significant difference in risk of death (4.3% vs. 3.5%, respectively; p=0.37) or heart attack (4.8% vs. 3.2%, respectively, p=0.11). The risk of stroke was significantly greater for bypass surgery (0.6% for PCI vs. 2.2% for bypass; p=0.003). Taken together as a composite, these three data points (death, heart attack, and stroke) show that PCI and bypass surgery stack up overall as equally safe options for patients with left main and multi-vessel coronary artery disease.

Less than 8% more PCI than bypass patients underwent either a second angioplasty procedure or bypass surgery by the end of the year following their procedure. "Historically speaking, this is remarkable," says Dr. Feldman. "It means that more than 85% of patients can choose the less-invasive angioplasty / stenting option and won't need another procedure a year later. On the revascularization question, we've never seen such a small difference between PCI and bypass surgery, even in less complex patients."

SCAI urges all patients and their physicians to consider the broad spectrum of care for treatment of cardiovascular disease, stressing that no single therapy is best for every patient. "All patients need to talk with their doctors about the best options for them as individuals, considering the status of their health and their desired outcomes for quality of life," says Dr. Ziyad M. Hijazi, SCAI President, Director of the Rush
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SOURCE Society for Cardiovascular Angiography and Interventions(SCAI)
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