03/12/2009 - News

Reflux Drugs May Interfere with the Benefit of Plavix

By: June Chen, MD

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Coronary artery bypass grafting (CABG) is the standard of care for patients with symptomatic coronary artery disease. However, technological advances in percutaneous coronary intervention (PCI), more commonly referred to as stenting, have made it a viable treatment option for patients with complex coronary artery disease. So, which is better? According to a new study published in the New England Journal of Medicine, CABG continues to be the standard of care for patients with three-vessel or left main coronary artery disease .

Investigators from the SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) trial randomly assigned 1800 patients with coronary artery disease involving three blood vessels or the left main coronary artery to either undergo CABG or PCI. These patients had all been previously evaluated by both a cardiac surgeon and an interventional cardiologist to determine that equivalent restoration of blood flow to the heart could be achieved with either treatment. The investigators found that the rate of major cardiac or cerebrovascular events was significantly higher in the PCI group at 12 months. The rates of death and heart attack at 12 months were similar between the two groups, but the occurrence of stroke was higher with CABG.

Based on these findings, the investigators concluded that CABG remains the standard of care for patients with three-vessel or left main disease. However, they point out that the 12-month follow-up period may not be long enough to sufficiently evaluate the long-term comparison between CABG and PCI.

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Created on: 03/12/2009
Reviewed on: 03/12/2009

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