Bypass preferred over stent

Bypass surgery remains the best option for heart patients with more than one clogged artery, according to the first big study to compare bypass with drug-coated stents. The new research dims hopes that the less drastic stent procedure would prove to be just as good for people with multiple blockages.

In the study, heart attack and death rates were lower among people who had surgery than those given artery-opening balloon angioplasty and stents -- mesh cylinders oozing drugs to keep vessels from re-clogging. It is the latest setback for drug-coated stents, which have revolutionized heart care and have been implanted in about 6 million people worldwide. They are far better at keeping vessels open than older bare metal stents. However, sales have been hurt in the last year by safety concerns and studies questioning the value of angioplasty for certain patients.

A second study gave stent makers some good news, finding that using these devices “off label,” in non-approved situations, is not as dangerous as many had feared.

Both studies were published in the Jan. 24 issue of the New England Journal of Medicine. Neither is definitive enough to resolve these issues, but they help guide doctors and patients confused about which treatment is best for whom.