Bypass Surgery vs. Stents: Which is Better for Quality of Life?

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For people with extensive coronary artery disease, bypass surgery may beat stents when it comes to boosting quality of life, according to a study in the Journal of the American College of Cardiology. When patients have more complex heart disease-such as blockages in three or more arteries-bypass surgery is more effective than implanting drug-coated stents: It cuts the risk of heart attack to a greater degree, and can lessen the need for a repeat artery-clearing procedure.

The study, which was published last year, looked at how patients fare day to day. Do bypass patients have less chest pain? Do they generally feel better physically and emotionally? The answer for all three points appears to be yes.

The results were based on 1,800 patients with extensive heart disease who were randomly assigned to receive either bypass surgery or drug-coated stents. Over the next five years, the patients periodically took surveys focused on their health-related quality of life.

On average, bypass patients gave somewhat higher ratings to their physical functioning and emotional well-being. They were also more likely to report reductions in their chest pain frequency-specifically, 22 percent of them reported such improvement, versus 17 percent of stent patients.

Bypass is generally preferred over stents for extensive coronary artery disease, and the new findings support that. But every treatment decision is individual; make sure you thoroughly discuss your options with your doctor.