Patients at risk of a serious heart attack will now have a treatment option other than open-heart surgery, cardiac experts have said.
Results of a European research trial announced at a major medical conference in Orlando, Florida, yesterday showed that the insertion of a balloon-like device, containing a drug, in people with coronary heart disease produced an outcome at least as good as that for those undergoing traditional bypass surgery.
For many years coronary artery bypass grafting has been the standard treatment for people with a number of blockages in different heart arteries. The evolution of a procedure called angioplasty, in which a device called a stent is placed in the affected artery by means of an incision in the groin, has significantly altered the treatment of people with a single blocked artery.
Dr Patrick Serruys, of the Erasmus Medical Centre in the Netherlands, told the annual scientific meeting of the American College of Cardiology in Orlando that the use of a stent containing an anti-clotting drug meant patients survived longer and had fewer complications than those treated with open-heart surgery.
Emphasising that bypass grafting was still an effective intervention, he said of the 607 patients with multivessel disease who were studied, those given the drug-eluting stent suffered fewer heart attacks and strokes in the year following treatment.
Referring to the results of this Arts II trial as a "major breakthrough", Dr Valentin Fuster, a New York cardiologist, said they showed for the first time that drug-eluting stents would have "more of an input" than bypass grafting in the treatment of people with multivessel coronary heart disease.
"Until now surgery was better in terms of preventing heart attack in these patients, but clearly something has happened with drug-eluting stents to change our view."
Separate research comparing the effectiveness of two different types of drug-containing stents found no difference in efficacy between the Cypher device and the Taxus device, which is made in Galway by the medical devices company Boston Scientific.
In this Reality study, 1,386 patients from 90 different centres in Europe, Latin America and Asia were given either the Cypher or Taxus stent. The patients included a number from the Republic who received their treatment at the Mater and St James's hospitals in Dublin.
The lead author of the study, Dr Marie-Claude Morice, of the Institut Jacques Cartier, Massy, France, told the conference that, after being followed up for eight months, patients given both devices did very well, with a success rate of over 95 per cent.
The researches found no difference in the rate at which participants' coronary arteries became reblocked after treatment.
The results of the Arts II and Reality studies had been eagerly awaited by heart specialists as a guide to treating patients with significant blockages in their coronary arteries.