The Syntax Study
Anja Behringer reports
Bypass or stent? In Germany alone, every year 370.000 patients have to decide which kind of surgery they will undergo. The Syntax study (Synergy between PCI with taxus and cardiac surgery), presented in September, looked at 1.720 patients and aims to provide help to answer this crucial question.
Presenting the study, Professor Friedhelm Beyersdorf, President of the German Society for Thoracic and Cardiovascular Surgery, summarized: “Particularly in severe cases, such as the so-called three vessel coronary artery diseases, bypass surgery is clearly superior to both the conventional and the drug-eluding stent implant with regard to death rate, myocardial infarction and repeat procedure.”
Approximately 80 percent of the patients receive one or several stent implants, while only 20 percent undergo bypass surgery. The Syntax study, however, indicates that in many cases the stent implant is not the right choice. Syntax, now in its third year, is the worldwide largest study jointly conducted by cardiologists and heart surgeons to compare the two therapies.
With a death rate of 10.8 percent for stent patients and 9.6 percent for bypass patients the two therapy options show very similar results two years after the intervention. This picture though is clearly different when complex diseases are involved such as left main stem coronary disease and three vessel occlusion: two years after the surgery, the death rate among stent patients was three times higher than that for bypass patients. The rate of post-intervention myocardial infarctions was at 5.9 percent for stent patients and thus significantly higher than the rate for bypass patients (3.3 percent).
Beyersdorf pointed out that these results confirm the German national guidelines for CHD published in June 2006.
26.01.2010
