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Society for Cardiovascular Angiography and Interventions (SCAI)

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 than
open-heart surgery, says The Society for Cardiovascular Angiography
and Interventions (SCAI). The one-year results of SYNTAX also show
that most patients with left main and multi-vessel disease who
undergo angioplasty and stenting will not need a second
revascularization procedure in the first year.
Until this morning's announcement at the European Society of
Cardiology Congress (Munich, Germany), patients with advanced and
anatomically complex coronary artery disease were advised to undergo
open-heart bypass surgery. The SYNTAX (SYNergy Between Percutaneous
Coronary Intervention with TAXUS and Cardiac Surgery) study found
that the less-invasive option of percutaneous coronary intervention
(PCI) with drug-eluting stents had rates of heart attack and death no
different from bypass surgery after one year.
"Starting today, I can tell my patients with left main and
multi-vessel disease that angioplasty and drug-eluting stents are
just as safe for them as surgery in terms of death or heart attack,"
says Dr. Ted Feldman, SCAI Past President, Professor of Medicine at
Northwestern University School of Medicine, Director of the Cardiac
Catheterization Laboratory at Evanston Hospital (Chicago, IL), and
SYNTAX Steering Committee member. "The SYNTAX results are good news
for patients and physicians because we now have another treatment
option for the most complex patients. PCI is less invasive than
surgery, and it takes days, not weeks, to recover from."
The results of SYNTAX have been eagerly anticipated because the
study is the first randomized comparison of PCI with drug-eluting
stents vs. bypass surgery in patients with the most complex coronary
artery 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 and
whether 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, SYNTAX
found 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 greater
for bypass surgery (0.6% for PCI vs. 2.2% for bypass; p=0.003). Taken
together as a composite, these three data points (death, heart
attack, and stroke) show that PCI and bypass surgery stack up overall
as equally safe options for patients with left main and multi-vessel
coronary artery disease.
Less than 8% more PCI than bypass patients underwent either a
second angioplasty procedure or bypass surgery by the end of the year
following their procedure. "Historically speaking, this is
remarkable," says Dr. Feldman. "It means that more than 85% of
patients can choose the less-invasive angioplasty / stenting option
and won't need another procedure a year later. On the
revascularization question, we've never seen such a small difference
between PCI and bypass surgery, even in less complex patients."
SCAI urges all patients and their physicians to consider the
broad spectrum of care for treatment of cardiovascular disease,
stressing that no single therapy is best for every patient. "All
patients need to talk with their doctors about the best options for
them as individuals, considering the status of their health and their
desired outcomes for quality of life," says Dr. Ziyad M. Hijazi, SCAI
President, Director of the Rush Center for Congenital & Structural
Heart Disease, Section Chief of Pediatric Cardiology, and Professor
of Pediatrics & Internal Medicine at Rush University Medical Center
(Chicago, IL).
"The take-away message is that SYNTAX has extended the spectrum
of care for a large number of patients with very complex coronary
artery disease. For some, bypass surgery will still be the most
appropriate option, but many more patients now have another choice,"
says Dr. Feldman.
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 Contacts Available for Interview: Ted Feldman, M.D.,
FSCAI, Past President, The Society for Cardiovascular Angiography and
Interventions (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 Disease
Section Chief, Pediatric Cardiology, and Professor of Pediatrics &
Internal Medicine, Rush University Medical Center Chicago, Illinois,
Tel: +1-717-422-1181, Email: kbdavid@scai.org