The controversy over whether patients with severe coronary artery disease (CAD) do better with stents or with bypass surgery continues, and the results of the SYNTAX trial, published in 2009, merely fanned the flames.
The SYNTAX trial randomized 1,800 patients with severe CAD to either bypass surgery or drug-eluting stents, and followed them for 12 months after their procedures. It was designed as a "non-inferiority" trial, that is, it was designed to demonstrate that stenting does not produce results significantly inferior to bypass surgery in these patients.
Unfortunately for fans of stenting, the SYNTAX study was negative. Stenting did NOT prove to be "non-inferior" to bypass surgery by the criteria laid out (that is, patients receiving stents had nearly 8% more of the bad endpoint events than patients having bypass surgery). Nonetheless, cardiologists have been quick to point out that patients randomized to stenting actually did better in some important respects than patients randomized to bypass surgery.
Read here about the SYNTAX trial and the controversy it has generated.
CABG x 4 in 1995 – the typical vessels. Two stents, Sept 2002, one repaired by brachytherapy March 2003. Third stent (drug eluting) April 2004. Mild heart attack Sept 2007, with two drug eluting stents placed (total 55 mm) upstream of the original stents.
With all this, I can say I believe the last stents would have required additional CABG had they occurred in the 90s.
I’m now on a 10,000 steps a day exercise regimen, watching my diet and hope I’ll never need anything more, but I’m no fool – I know I’ll need more.
The advantage of stents is the short procedure time along with rapid return to normal activity versus the very long recovery with a CABG. Obviously the potential of a stroke with stents is a bummer.
I had a very unexpected triple by pass on April 3, 2002. Recovered very rapidly & have never had a problem since. Last year my doctor put me through several nuclear heart tests, I was fine. The surgery works far better than the meds in my humble opinion. Have already had 7 extra years added to my life & plan to have many more.
I had a stent put in TC1 which is the communal trunk in 1990 and have had a very normal and healthy live after that up till now and hope to have many more years to come.
i had stints put in two times did not help still get aginan pains when i excrise