Comparing the Safety and Efficacy of Heart Bypass Surgery and Angioplasty

Researchers at the University of California, Los Angeles, have completed a comparative review of heart bypass surgery and angioplasty that examined the safety and efficacy of each for the treatment of heart blockages.

A new study from researchers at the University of California, Los Angeles, compares the safety and efficacy of heart bypass surgery, the standard option for blockages in the heart, to angioplasty, finding that the risks and benefits of each procedure do not make one superior to the other.

Michael Lee, MD, an interventional cardiologist at UCLA’s David Geffen School of Medicine, and his research team analyzed the mortality and risk factors reported in eight clinical studies that compared the procedures. At the one-year follow-up point, the risk of death or heart attack was not significantly different for patients who had undergone bypass surgery or angioplasty with drug-eluting stents. Patients with stents were at a significantly lower risk for stroke, but these same patients were at a significantly higher risk of an artery re-clogging.

"There are benefits and risks to both procedures and our analysis shows that for select patients, drug-eluting stenting may be a good alternative," said Lee, who is also the first author of the paper published in the American Journal of Cardiology.

The eight clinical studies that the researchers used for this analysis took place between 2000 and 2009 and included more than 2,900 patients.

According to Lee, a number of factors may influence why angioplasty may be a better option for one patient, while bypass surgery is the optimal treatment for the next, such as the patient’s age and how many arteries are affected. However, he feels that the outcome of this study is a good first step in understanding the influence that new procedures like angioplasty may have on patients’ treatment options.

"With the advent of more minimally invasive heart procedures, the medical field is exploring additional options for treating patients beyond surgical standards," said Lee. "Studies such as ours will help us better understand the impact of these new procedures and their role as possible new treatment options."