Comparison of Heart Stent Procedures and Surgical Treatments Over About 12 Years: "No Difference in Mortality Rates"

Seoul Asan Hospital Cardiology Professors Jeongmin An and Doyoon Kang Team
Published in the World-Renowned Journal 'Circulation'

Professor An Jung-min (right) and Professor Kang Do-yoon of the Department of Cardiology at Asan Medical Center in Seoul are performing a stent procedure.
[Photo by Asan Medical Center, Seoul]

[Asia Economy Reporter Lee Gwan-joo] A long-standing debate in the field of cardiology regarding the outcomes of coronary artery stent procedures versus surgical treatment has been tracked and observed for the longest period ever?approximately 12 years?with results showing no difference in mortality rates between the two treatment methods.

The cardiology team led by Professors Ahn Jung-min and Kang Do-yoon at Seoul Asan Medical Center randomly assigned 880 patients with coronary artery multivessel disease to either stent procedures or surgical treatment and followed them for about 12 years. They concluded that there was no significant difference in stroke, major cardiac events, or mortality rates between the two patient groups, the team announced on the 12th.

The research team compared 438 patients who underwent drug-eluting stent procedures and 442 patients who received surgical treatment at 27 institutions nationwide from July 2008 to September 2013 among multivessel disease patients. The average age at the time of treatment was similar between the two groups: 64 years for the stent procedure group and 64.9 years for the surgical treatment group.

The average follow-up period for both groups was 11.8 years. The incidence rates of death, stroke, and major cardiac events were 28.8% in the stent procedure group and 27.1% in the surgical treatment group, showing no significant difference. However, the incidence of myocardial infarction after the procedure was slightly higher in the stent group at 7.1%, compared to 3.8% in the surgical group. Additionally, the probability of requiring re-intervention due to recurrence was higher in the stent group at 22.6%, compared to 12.7% in the surgical group, nearly 10 percentage points higher due to the nature of the treatment methods.

However, since these figures do not directly cause death, the researchers explained that stent procedures can be a sufficient alternative for high-risk patients who find surgery difficult or who have concerns about open-heart surgery. Professor Ahn stated, “This study is the longest follow-up of the treatment effects of stent procedures among global studies on coronary artery multivessel disease,” adding, “There has been controversy over the comparative effectiveness of treatment methods for coronary artery multivessel disease, but this study proves that stent procedures are as safe and effective as surgery.”

This study was presented by Professor Ahn at the recent Transcatheter Cardiovascular Therapeutics (TCT) conference held in Boston, USA, and was simultaneously published in real-time in 'Circulation,' the official journal of the American Heart Association, which is the most prestigious journal in the field of cardiology.

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