Bypass surgery is more cost-effective than percutaneous coronary interventions for most patients with multivessel or left main coronary artery disease

Commentary on: Cohen DJ, Osnabrugge RL, Magnuson EA, et al; SYNTAX Trial Investigators. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents versus bypass surgery for patients with 3-vessel or left main coronary artery disease: final results from the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation 2014;130:1146–57. Context The SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) trial compared outcomes of percutaneous coronary intervention (PCI) with drug eluting stents (DES) and coronary artery bypass grafting (CABG) among patients with three-vessel or left main coronary artery disease (CAD).1 At 5-year follow-up, there was a lower incidence of a composite of cardiovascular death, myocardial infarction (MI), stroke or repeat vascularisation among patients undergoing CABG, compared with PCI. This was primarily driven by reductions in MI and repeat vascularisation.2 The authors performed a prospective health economic evaluation comparing...

Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Agarwal, S., Kapadia, S. R. Tags: Health policy, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Health economics, Health service research Economic analysis Source Type: research