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Society for Cardiovascular Angiography and Interventions (SCAI)

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 Surgery
for Safety and Effectiveness in Patients with Complex Medical
Condition
Patients with both diabetes and advanced blockages in at least
three heart vessels will find good news in new findings announced
today from the CARDia trial, says The Society for Cardiovascular
Angiography and Interventions (SCAI). The one-year findings of the
new study indicate that these patients can safely choose to undergo
angioplasty 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 trial
comparing percutaneous coronary intervention (PCI) vs. open-heart
surgery in patients typically considered to be poor candidates for
angioplasty and stenting. Since the combination of diabetes and
multi-vessel coronary artery disease has long been considered the
domain of surgeons, their findings surprised some: The patients who
underwent PCI rather that surgery did just as well as the surgery
patients on the primary endpoint of death, heart attack, and stroke.
In addition, the PCI patients experienced fewer strokes and less
bleeding.
This finding differs from earlier trials comparing PCI and
surgery in these patients, perhaps because drug-eluting stents have
been added to the mix, suggest SCAI leaders. "The take-away message
is that diabetic patients with complex coronary artery disease may
now be able to choose angioplasty and stenting over bypass surgery,"
says Dr. Bonnie Weiner, SCAI Immediate Past President, Professor of
Medicine, and Director of Interventional Cardiology Research at St.
Vincent Hospital at Worcester Medical Center (Worcester, MA). "It's
important to realize that this is one trial and the first-year
findings, but it's a good sign for patients because it could
ultimately broaden their options."
CARDia also examined whether, after undergoing PCI or surgery,
patients required a repeat procedure. The difference in repeat
revascularization between PCI and bypass surgery was very small but
statistically significant, despite an unusually low rate for both
groups (9.9% for PCI vs. 2.0% for bypass; p=0.001). Further, when the
patients who received drug-eluting stents (rather than bare metal
stents 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 less
important (7.3% for PCI vs. 2.0% for bypass; p=0.013). This
represented about two-thirds of the study population and more closely
reflects current practices.
"When you compare only the patients who had angioplasty with
drug-eluting stents with the bypass surgery patients, you find very
similar repeat revascularization rates," says Dr. Weiner. "We'll want
to see if these findings continue as the follow-up proceeds since the
surgery patients are less likely to have repeat revascularization
procedures this early, but it's a very good sign for patients who are
candidates for PCI and prefer it because it is less invasive and
easier to recover from than surgery. In our view, this is very good
news for patients because it gives them more options for their care."
About SCAI
Headquartered in Washington, D.C., The Society for Cardiovascular
Angiography and Interventions is a 4,000-member professional
organization representing invasive and interventional cardiologists
in more than 60 countries. SCAI's mission is to promote excellence in
invasive and interventional cardiovascular medicine through physician
education and representation, and advancement of quality standards to
enhance patient care. SCAI's annual meeting has become the leading
venue for education, discussion, and debate about the latest
developments in this dynamic medical specialty. SCAI's new patient
and physician education program, Seconds Count, offers comprehensive
information about cardiovascular disease. For more information about
SCAI and Seconds Count, visit www.scai.org or www.seconds-count.org.
Web site: http://www.scai.org
              http://www.seconds-count.org

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

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  • 01.09.2008 – 14:43

    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 Effective in Patients for Whom Standard Therapy Has Been Open-Heart Surgery Data announced today from the landmark SYNTAX trial indicate that patients with very complex coronary artery disease can safely choose to be treated with angioplasty and drug-eluting stents rather ...