Magazin

2008-09-01

SCAI: CARDia Data Find Diabetic Patients With Complex Heart Disease Can Safely Choose PCI


Washington (ots/PRNewswire) -

- At One Year, Angioplasty and Stenting Matches Bypass Surgeryfor Safety and Effectiveness in Patients with Complex MedicalCondition

Patients with both diabetes and advanced blockages in at leastthree heart vessels will find good news in new findings announcedtoday from the CARDia trial, says The Society for CardiovascularAngiography and Interventions (SCAI). The one-year findings of thenew study indicate that these patients can safely choose to undergoangioplasty and stenting rather than open-heart surgery.

At the European Society of Cardiology Congress (Munich, Germany),investigators from the United Kingdom presented the results of CARDia(Coronary Artery Revascularization in Diabetes), a clinical trialcomparing percutaneous coronary intervention (PCI) vs. open-heartsurgery in patients typically considered to be poor candidates forangioplasty and stenting. Since the combination of diabetes andmulti-vessel coronary artery disease has long been considered thedomain of surgeons, their findings surprised some: The patients whounderwent PCI rather that surgery did just as well as the surgerypatients on the primary endpoint of death, heart attack, and stroke.In addition, the PCI patients experienced fewer strokes and lessbleeding.

This finding differs from earlier trials comparing PCI andsurgery in these patients, perhaps because drug-eluting stents havebeen added to the mix, suggest SCAI leaders. "The take-away messageis that diabetic patients with complex coronary artery disease maynow be able to choose angioplasty and stenting over bypass surgery,"says Dr. Bonnie Weiner, SCAI Immediate Past President, Professor ofMedicine, and Director of Interventional Cardiology Research at St.Vincent Hospital at Worcester Medical Center (Worcester, MA). "It'simportant to realize that this is one trial and the first-yearfindings, but it's a good sign for patients because it couldultimately broaden their options."

CARDia also examined whether, after undergoing PCI or surgery,patients required a repeat procedure. The difference in repeatrevascularization between PCI and bypass surgery was very small butstatistically significant, despite an unusually low rate for bothgroups (9.9% for PCI vs. 2.0% for bypass; p=0.001). Further, when thepatients who received drug-eluting stents (rather than bare metalstents or the entire study population) were specifically analyzed,the difference in revascularization in the PCI group was even lower,and the difference in the rates of repeat revascularization was lessimportant (7.3% for PCI vs. 2.0% for bypass; p=0.013). Thisrepresented about two-thirds of the study population and more closelyreflects current practices.

"When you compare only the patients who had angioplasty withdrug-eluting stents with the bypass surgery patients, you find verysimilar repeat revascularization rates," says Dr. Weiner. "We'll wantto see if these findings continue as the follow-up proceeds since thesurgery patients are less likely to have repeat revascularizationprocedures this early, but it's a very good sign for patients who arecandidates for PCI and prefer it because it is less invasive andeasier to recover from than surgery. In our view, this is very goodnews for patients because it gives them more options for their care."

About SCAI

Headquartered in Washington, D.C., The Society for CardiovascularAngiography and Interventions is a 4,000-member professionalorganization representing invasive and interventional cardiologistsin more than 60 countries. SCAI's mission is to promote excellence ininvasive and interventional cardiovascular medicine through physicianeducation and representation, and advancement of quality standards toenhance patient care. SCAI's annual meeting has become the leadingvenue for education, discussion, and debate about the latestdevelopments in this dynamic medical specialty. SCAI's new patientand physician education program, Seconds Count, offers comprehensiveinformation about cardiovascular disease. For more information aboutSCAI and Seconds Count, visit www.scai.org or www.seconds-count.org.

Web site: http://www.scai.org http://www.seconds-count.org

ots Originaltext: Society for Cardiovascular Angiography and Interventions (SCAI)Im Internet recherchierbar: http://www.presseportal.de

Contact:Kathy Boyd David, +1-717-422-1181, kbdavid@scai.org, for Society for Cardiovascular Angiography and Interventions (SCAI). / Note to Editors: SCAI Contact Available for Interview: Bonnie H. Weiner, M.D., MSEC, MBA, FSCAI, Immediate Past President, The Society for Cardiovascular Angiography and Interventions, Professor of Medicine and Director of Interventional Cardiology Research St. Vincent Hospital at Worcester Medical Center, Worcester, Massachusetts, Tel: +1-717-422-1181, Email: kbdavid@scai.org

Society for Cardiovascular Angiography and Interventions (SCAI)

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