NEW YORK (Reuters Health) - Outcomes following commonly performed heart procedures appear to have improved since the mid-1990s, researchers report based on data they analyzed.
The data also show that survival after heart bypass surgery or first-time angioplasty is similar, Dr. Iain B. Squire from the University of Leicester, UK, told Reuters Health. He pointed out, however, that the need for a further procedure is much higher if the first procedure is angioplasty or other “percutaneous coronary intervention” (PCI).
Coronary-artery bypass grafting, known as CABG, involves stitching in a vein or artery to go around a blocked artery. PCI involves inserting and inflating tiny balloons into vessels to widen narrowed arteries, often with placement of mesh tubes called stents to keep the artery open.
Squire and colleagues investigated trends in outcomes following first heart revascularization procedures between 1995-1996 and 2003-2004.
They found that death from any cause as late as 2 years after revascularization was less than 5 percent with PCI and bypass surgery, but patients were nearly 11 times more likely to have a repeat procedure after PCI than after bypass surgery.
Over the study period, 2-year survival improved significantly from roughly 94 percent to 96 percent after bypass surgery and from 94 percent to 97 percent after PCI.
There was also significant improvement in 2-year “event-free” survival - that is, survival free of a heart-related event like a heart attack. Two-year event-free survival improved from 72 percent to 84 percent in the PCI patients, while this parameter remained steady at around 95 percent for the bypass patients.
In the PCI group, use of stents to prop open a clogged artery was associated with lower risks of repeat procedure, death, and hospital admission, which translated into a lower overall risk of major adverse events, like heart attack and stroke, the researchers report.
“For patients being considered for elective revascularization, our data suggest that physicians are making appropriate decisions (as indicated by excellent survival) for individual patients,” Squire said.
SOURCE: Heart, January 2009.