A review shows that patients with moderate coronary artery disease are more likely to be free of recurring angina if they have bypass surgery rather than balloon angioplasty, with or without a stent. Moderate disease was defined as one blockage in the vital left anterior descending artery, two blockages, or in some less severe cases three.
The review, published in the Annals of Internal Medicine, was carried out for the US Agency for Healthcare Research and Quality (AHRQ). When medicines fail to relieve angina, patients usually have either surgery or angioplasty. Angioplasty used to be preferred first to spare patients surgery and its risks in the first 30 days. The review found:
- Survival was the same with either treatment: about 98.5% at 30 days after surgery or angioplasty (with or without stents).
- 84% of surgery patients were free of angina for a year, against 75% after angioplasty; the gap narrowed over time, but patients stayed well for five years.
- About 4% of surgery patients needed another procedure in the first year and 10% within five years, while after angioplasty more than 24% needed another procedure within a year and more than 33% within five years.
- The risk of stroke in the 30 days after surgery was about 0.6% higher than after angioplasty.
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