American Heart Association's Scientific Sessions Presentation: Bypass
Surgery And Angioplasty With Stent May Affect Women And Men Differently
CHICAGO -- Two revascularization procedures -- Percutaneous coronary>
intervention (PCI) and coronary artery bypass graft (CABG) surgery --
are commonly performed on both women and men with coronary artery disease
(CAD). But do these procedures affect symptom relief and quality of
life differently, depending on gender?
At the American Heart Association's
Scientific Sessions today, Zefeng Zhang, M.D., Ph.D., post-doc fellow
at the Emory Center for Outcomes Research (ECOR) is presenting the results
of the Stent or Surgery (SoS )Trial which addressed that question. "We
found that among men, CABG may be superior to PCI for improving quality
of life. However, in women, these procedures are equally effective,"
Dr. Zhang says.
The research team (which
also included Emory cardiologist and epidemiologist Viola Vaccarino,
M.D., Ph.D., Elizabeth Mahoney, Ph.D., Assistant Professor of Medicine
at the Emory University School of Medicine, and researchers at Royal
Brompton Hospital, Mid America Heart Institute, and the Cardiothoracic
Center Liverpool) randomized 988 patients with multi-vessel CAD from
November, 1996 to December, 2000. About one half underwent CABG (392
men and 108 women) while the others (390 men and 98 women) received
PCI with stents - tiny metal sheaths that help keep arteries open after
"Our most important findings
are that, regardless of gender, CABG and PCI with stents dramatically
improved cardiac-related health status within one year post-intervention
in patients with multi-vessel coronary disease. Both CABG and PCI are
effective interventions for the relief of angina. However, in men, CABG
was associated with more benefits than PCI," says Dr. Zhang."
He explains that, at six
months, both men and women tended to show greater improvements in function
and quality of life assessments with CABG than PCI. However, after a
year, the men who had undergone CABG continued to have increased improvements.
For women, CABG and PCI showed similar health benefits at one year.
"The SoS study suggests that
CABG and PCI do affect male and female patients differently, at least
in the short term," Dr. Zhang concludes. " However, further study will
be necessary to determine whether the relative difference of CABG versus
PCI in cardiac-related health status between women and men found in
our study can be generalized to other patient samples."
The Emory Heart Center
is comprised of all cardiology services and research at Emory University
Hospital (EUH), Emory Crawford Long Hospital (ECLH) Carlyle Fraser Heart
Center, the Andreas Gruentzig Cardiovascular Center of Emory University
and the Emory Clinic. Ranked in the top ten of U.S. News & World Report's
annual survey of the nation's best Heart Centers, the Emory Heart Center
has a rich history of excellence in all areas of cardiology - including
education, research and patient care. It is also internationally recognized
as one of the birthplaces of modern interventional cardiology.