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  • Stents had similar clinical outcomes but more repeated revascularisation than did bypass surgery in multivessel disease

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Therapeutics
Stents had similar clinical outcomes but more repeated revascularisation than did bypass surgery in multivessel disease

https://doi.org/10.1136/ebm.6.6.174

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    (2001) N Engl J Med 344, 1117. Serruys PW, Unger F, Sousa JE, et al,. for the Arterial Revascularization Therapies Study Group.. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease.. Apr 12;. :. –24.
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 QUESTION: In patients with multivessel coronary artery disease, how effective and cost effective is coronary stenting compared with bypass surgery for reducing clinical outcomes at 1 year?

    Design

    Randomised (allocation concealed*), unblinded,* controlled trial with 12 months of follow up (Arterial Revascularization Therapies Study [ARTS]).

    Setting

    67 centres in 19 countries.

    Patients

    1205 patients (mean age 61 y, 77% men) with angina pectoris or silent ischaemia plus ≥ 2 lesions in different vessels or territories that were amenable to stenting. Exclusion criteria included previous bypass surgery, ejection fraction ≤ 30%, congestive heart failure, history of stroke, and recent transmural myocardial infarction (MI). 99% of patients in the stent group and 96% in the bypass surgery group received their allocated treatment.

    Intervention

    600 patients were allocated to stenting …

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    Footnotes

    • Source of funding: Cordis.

    • For correspondence:Dr P W Serruys, Department of Interventional Cardiology Heart Center, Erasmus University Rotterdam and Dr Molewaterplein, 40, 3015 GD Rotterdam, The Netherlands. Fax +31 10 4369154.

    • ↵* See glossary.