Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty

F.D. Eefting; H.M. Nathoe; D. van Dijk; E.W.L. Jansen; J.R. Lahpor; P.R. Stella; W.J.L. Suyker; J.C. Diephuis; H. Suryapranata; J.M.P.G Ernst; C. Borst; E. Buskens; D.E. Grobbee; P.P.T. de Jaegere

doi:10.1161/01.CIR.0000100723.50363.2C

Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty

F.D. Eefting, H.M. Nathoe, D. van Dijk, E.W.L. Jansen, J.R. Lahpor, P.R. Stella, W.J.L. Suyker, J.C. Diephuis, H. Suryapranata, J.M.P.G Ernst, C. Borst, E. Buskens, D.E. Grobbee, P.P.T. de Jaegere

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Stenting improves cardiac outcome in comparison with balloon angioplasty. Compared with conventional surgery, off-pump bypass surgery on the beating heart without cardiopulmonary bypass may reduce morbidity, hospital stay, and costs. The purpose, therefore, was to compare cardiac outcome, quality of life, and cost-effectiveness 1 year after stenting and after off-pump surgery.

METHODS AND RESULTS: Patients referred for angioplasty (n=280) were randomly assigned to stenting (n=138) or off-pump bypass surgery. At 1 year, survival free from stroke, myocardial infarction, and repeat revascularization was 85.5% after stenting and 91.5% after off-pump surgery (relative risk, 0.93; 95% CI, 0.86 to 1.02). Freedom from angina was 78.3% after stenting and 87.0% after off-pump surgery (P=0.06). Quality-adjusted lifetime was 0.82 year after stenting and 0.79 year after off-pump surgery (P=0.09). Hospital stay after the initial procedure was 1.43 and 5.77 days, respectively (P<0.01). Stenting reduced overall costs by 2933 dollars (26.2%) per patient (8276 dollars versus 11 209 dollars; P<0.01). Stenting was more cost-effective in 95% of the bootstrap estimates.

CONCLUSIONS: At 1 year, stenting was more cost-effective than off-pump surgery while maintaining comparable cardiac outcome and quality of life. Stenting rather than off-pump surgery, therefore, can be recommended as a first-choice revascularization strategy in selected patients.

Original language	English
Pages (from-to)	2870-2876
Number of pages	7
Journal	Circulation
Volume	108
Issue number	23
DOIs	https://doi.org/10.1161/01.CIR.0000100723.50363.2C
Publication status	Published - 9 Dec 2003

Keywords

Aged
Angina Pectoris
Angioplasty, Balloon
Coronary Artery Bypass
Cost-Benefit Analysis
Female
Follow-Up Studies
Humans
Life Tables
Male
Middle Aged
Myocardial Infarction
Netherlands
Quality-Adjusted Life Years
Questionnaires
Recurrence
Stents
Stroke
Treatment Outcome

Access to Document

10.1161/01.CIR.0000100723.50363.2C

Cite this

Eefting, F. D., Nathoe, H. M., van Dijk, D., Jansen, E. W. L., Lahpor, J. R., Stella, P. R., Suyker, W. J. L., Diephuis, J. C., Suryapranata, H., Ernst, J. M. P. G., Borst, C., Buskens, E., Grobbee, D. E., & de Jaegere, P. P. T. (2003). Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty. Circulation, 108(23), 2870-2876. https://doi.org/10.1161/01.CIR.0000100723.50363.2C

@article{eb05584a6d734d68a77d28c53bcf675d,

title = "Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty",

abstract = "BACKGROUND: Stenting improves cardiac outcome in comparison with balloon angioplasty. Compared with conventional surgery, off-pump bypass surgery on the beating heart without cardiopulmonary bypass may reduce morbidity, hospital stay, and costs. The purpose, therefore, was to compare cardiac outcome, quality of life, and cost-effectiveness 1 year after stenting and after off-pump surgery.METHODS AND RESULTS: Patients referred for angioplasty (n=280) were randomly assigned to stenting (n=138) or off-pump bypass surgery. At 1 year, survival free from stroke, myocardial infarction, and repeat revascularization was 85.5% after stenting and 91.5% after off-pump surgery (relative risk, 0.93; 95% CI, 0.86 to 1.02). Freedom from angina was 78.3% after stenting and 87.0% after off-pump surgery (P=0.06). Quality-adjusted lifetime was 0.82 year after stenting and 0.79 year after off-pump surgery (P=0.09). Hospital stay after the initial procedure was 1.43 and 5.77 days, respectively (P<0.01). Stenting reduced overall costs by 2933 dollars (26.2%) per patient (8276 dollars versus 11 209 dollars; P<0.01). Stenting was more cost-effective in 95% of the bootstrap estimates.CONCLUSIONS: At 1 year, stenting was more cost-effective than off-pump surgery while maintaining comparable cardiac outcome and quality of life. Stenting rather than off-pump surgery, therefore, can be recommended as a first-choice revascularization strategy in selected patients.",

keywords = "Aged, Angina Pectoris, Angioplasty, Balloon, Coronary Artery Bypass, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Life Tables, Male, Middle Aged, Myocardial Infarction, Netherlands, Quality-Adjusted Life Years, Questionnaires, Recurrence, Stents, Stroke, Treatment Outcome",

author = "F.D. Eefting and H.M. Nathoe and {van Dijk}, D. and E.W.L. Jansen and J.R. Lahpor and P.R. Stella and W.J.L. Suyker and J.C. Diephuis and H. Suryapranata and J.M.P.G Ernst and C. Borst and E. Buskens and D.E. Grobbee and {de Jaegere}, P.P.T.",

year = "2003",

month = dec,

day = "9",

doi = "10.1161/01.CIR.0000100723.50363.2C",

language = "English",

volume = "108",

pages = "2870--2876",

journal = "Circulation",

issn = "0009-7322",

publisher = "Lippincott Williams & Wilkins",

number = "23",

}

Eefting, FD, Nathoe, HM, van Dijk, D, Jansen, EWL, Lahpor, JR, Stella, PR, Suyker, WJL, Diephuis, JC, Suryapranata, H, Ernst, JMPG, Borst, C, Buskens, E, Grobbee, DE & de Jaegere, PPT 2003, 'Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty', Circulation, vol. 108, no. 23, pp. 2870-2876. https://doi.org/10.1161/01.CIR.0000100723.50363.2C

TY - JOUR

T1 - Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty

AU - Eefting, F.D.

AU - Nathoe, H.M.

AU - van Dijk, D.

AU - Jansen, E.W.L.

AU - Lahpor, J.R.

AU - Stella, P.R.

AU - Suyker, W.J.L.

AU - Diephuis, J.C.

AU - Suryapranata, H.

AU - Ernst, J.M.P.G

AU - Borst, C.

AU - Buskens, E.

AU - Grobbee, D.E.

AU - de Jaegere, P.P.T.

PY - 2003/12/9

Y1 - 2003/12/9

N2 - BACKGROUND: Stenting improves cardiac outcome in comparison with balloon angioplasty. Compared with conventional surgery, off-pump bypass surgery on the beating heart without cardiopulmonary bypass may reduce morbidity, hospital stay, and costs. The purpose, therefore, was to compare cardiac outcome, quality of life, and cost-effectiveness 1 year after stenting and after off-pump surgery.METHODS AND RESULTS: Patients referred for angioplasty (n=280) were randomly assigned to stenting (n=138) or off-pump bypass surgery. At 1 year, survival free from stroke, myocardial infarction, and repeat revascularization was 85.5% after stenting and 91.5% after off-pump surgery (relative risk, 0.93; 95% CI, 0.86 to 1.02). Freedom from angina was 78.3% after stenting and 87.0% after off-pump surgery (P=0.06). Quality-adjusted lifetime was 0.82 year after stenting and 0.79 year after off-pump surgery (P=0.09). Hospital stay after the initial procedure was 1.43 and 5.77 days, respectively (P<0.01). Stenting reduced overall costs by 2933 dollars (26.2%) per patient (8276 dollars versus 11 209 dollars; P<0.01). Stenting was more cost-effective in 95% of the bootstrap estimates.CONCLUSIONS: At 1 year, stenting was more cost-effective than off-pump surgery while maintaining comparable cardiac outcome and quality of life. Stenting rather than off-pump surgery, therefore, can be recommended as a first-choice revascularization strategy in selected patients.

AB - BACKGROUND: Stenting improves cardiac outcome in comparison with balloon angioplasty. Compared with conventional surgery, off-pump bypass surgery on the beating heart without cardiopulmonary bypass may reduce morbidity, hospital stay, and costs. The purpose, therefore, was to compare cardiac outcome, quality of life, and cost-effectiveness 1 year after stenting and after off-pump surgery.METHODS AND RESULTS: Patients referred for angioplasty (n=280) were randomly assigned to stenting (n=138) or off-pump bypass surgery. At 1 year, survival free from stroke, myocardial infarction, and repeat revascularization was 85.5% after stenting and 91.5% after off-pump surgery (relative risk, 0.93; 95% CI, 0.86 to 1.02). Freedom from angina was 78.3% after stenting and 87.0% after off-pump surgery (P=0.06). Quality-adjusted lifetime was 0.82 year after stenting and 0.79 year after off-pump surgery (P=0.09). Hospital stay after the initial procedure was 1.43 and 5.77 days, respectively (P<0.01). Stenting reduced overall costs by 2933 dollars (26.2%) per patient (8276 dollars versus 11 209 dollars; P<0.01). Stenting was more cost-effective in 95% of the bootstrap estimates.CONCLUSIONS: At 1 year, stenting was more cost-effective than off-pump surgery while maintaining comparable cardiac outcome and quality of life. Stenting rather than off-pump surgery, therefore, can be recommended as a first-choice revascularization strategy in selected patients.

KW - Aged

KW - Angina Pectoris

KW - Angioplasty, Balloon

KW - Coronary Artery Bypass

KW - Cost-Benefit Analysis

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Life Tables

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Netherlands

KW - Quality-Adjusted Life Years

KW - Questionnaires

KW - Recurrence

KW - Stents

KW - Stroke

KW - Treatment Outcome

U2 - 10.1161/01.CIR.0000100723.50363.2C

DO - 10.1161/01.CIR.0000100723.50363.2C

M3 - Article

C2 - 14656913

SN - 0009-7322

VL - 108

SP - 2870

EP - 2876

JO - Circulation

JF - Circulation

IS - 23

ER -

Randomized comparison between stenting and off-pump bypass surgery in patients referred for angioplasty

Abstract

Keywords

Access to Document

Fingerprint

Cite this