2008-09-01

SCAI: SYNTAX Data Show PCI Is a Good Option for Patients With Complex Coronary Artery Disease


Washington (ots/PRNewswire) -

- One-Year Data Find Angioplasty and Stenting Safe and Effectivein Patients for Whom Standard Therapy Has Been Open-Heart Surgery

Data announced today from the landmark SYNTAX trial indicate thatpatients with very complex coronary artery disease can safely chooseto be treated with angioplasty and drug-eluting stents rather thanopen-heart surgery, says The Society for Cardiovascular Angiographyand Interventions (SCAI). The one-year results of SYNTAX also showthat most patients with left main and multi-vessel disease whoundergo angioplasty and stenting will not need a secondrevascularization procedure in the first year.

Until this morning's announcement at the European Society ofCardiology Congress (Munich, Germany), patients with advanced andanatomically complex coronary artery disease were advised to undergoopen-heart bypass surgery. The SYNTAX (SYNergy Between PercutaneousCoronary Intervention with TAXUS and Cardiac Surgery) study foundthat the less-invasive option of percutaneous coronary intervention(PCI) with drug-eluting stents had rates of heart attack and death nodifferent from bypass surgery after one year.

"Starting today, I can tell my patients with left main andmulti-vessel disease that angioplasty and drug-eluting stents arejust as safe for them as surgery in terms of death or heart attack,"says Dr. Ted Feldman, SCAI Past President, Professor of Medicine atNorthwestern University School of Medicine, Director of the CardiacCatheterization Laboratory at Evanston Hospital (Chicago, IL), andSYNTAX Steering Committee member. "The SYNTAX results are good newsfor patients and physicians because we now have another treatmentoption for the most complex patients. PCI is less invasive thansurgery, and it takes days, not weeks, to recover from."

The results of SYNTAX have been eagerly anticipated because thestudy is the first randomized comparison of PCI with drug-elutingstents vs. bypass surgery in patients with the most complex coronaryartery disease -- left main stenosis and three-vessel disease.Today's presentation revealed findings for the primary endpoint,focusing on the safety and effectiveness of the two therapies andwhether either group experienced more heart attack, stroke, or death,or was more likely to require repeat revascularization procedures(either a second PCI or bypass surgery) by the end of the first year.

In its head-to-head comparison of PCI vs. bypass surgery, SYNTAXfound no statistically significant difference in risk of death (4.3%vs. 3.5%, respectively; p=0.37) or heart attack (4.8% vs. 3.2%,respectively, p=0.11). The risk of stroke was significantly greaterfor bypass surgery (0.6% for PCI vs. 2.2% for bypass; p=0.003). Takentogether as a composite, these three data points (death, heartattack, and stroke) show that PCI and bypass surgery stack up overallas equally safe options for patients with left main and multi-vesselcoronary artery disease.

Less than 8% more PCI than bypass patients underwent either asecond angioplasty procedure or bypass surgery by the end of the yearfollowing their procedure. "Historically speaking, this isremarkable," says Dr. Feldman. "It means that more than 85% ofpatients can choose the less-invasive angioplasty / stenting optionand won't need another procedure a year later. On therevascularization question, we've never seen such a small differencebetween PCI and bypass surgery, even in less complex patients."

SCAI urges all patients and their physicians to consider thebroad spectrum of care for treatment of cardiovascular disease,stressing that no single therapy is best for every patient. "Allpatients need to talk with their doctors about the best options forthem as individuals, considering the status of their health and theirdesired outcomes for quality of life," says Dr. Ziyad M. Hijazi, SCAIPresident, Director of the Rush Center for Congenital & StructuralHeart Disease, Section Chief of Pediatric Cardiology, and Professorof Pediatrics & Internal Medicine at Rush University Medical Center(Chicago, IL).

"The take-away message is that SYNTAX has extended the spectrumof care for a large number of patients with very complex coronaryartery disease. For some, bypass surgery will still be the mostappropriate option, but many more patients now have another choice,"says Dr. Feldman.

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 Contacts Available for Interview: Ted Feldman, M.D., FSCAI, Past President, The Society for Cardiovascular Angiography andInterventions (SCAI); Professor of Medicine, Northwestern University School of Medicine Director, Cardiac Catheterization Laboratory, Evanston Hospital, Chicago, Illinois, Tel: +1-717-422-1181, Email: kbdavid@scai.org; Ziyad M. Hijazi, MD, MPH, FSCAI, President, The Society for Cardiovascular Angiography and Interventions (SCAI)Director, Rush Center for Congenital & Structural Heart DiseaseSection Chief, Pediatric Cardiology, and Professor of Pediatrics & Internal Medicine, Rush University Medical Center Chicago, Illinois, Tel: +1-717-422-1181, Email: kbdavid@scai.org

Society for Cardiovascular Angiography and Interventions (SCAI)

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SCAI: SYNTAX Data Show PCI Is a Good Option for Patients With Complex Coronary Artery Disease

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