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SYNTAX: Angina slightly improved in CABG vs. PCI patients
Cohen D. N Engl J Med. 2011;364:1016-1026.
A new quality-of-life substudy of the SYNTAX trial has shown that among patients with three-vessel or left main coronary artery disease, there was greater angina relief in those treated with CABG compared with percutaneous coronary intervention at 6 and 12 months.
In the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) trial, a group of investigators allocated 1,800 patients (mean age, 65 years) with three-vessel disease or left main CAD to be treated with either PCI with paclitaxel-eluting stents (Taxus, Boston Scientific; n=903) or CABG (n=897). Using the Seattle Angina Questionnaire (SAQ) and the Medical Outcomes Study 36-Item Short-Form Health Survey, they then assessed health-related quality of life at four intervals: baseline, 1 month, 6 months and 12 months.
At 6 and 12 months vs. baseline, both groups had significantly higher scores with both surveys, indicating better health status. A greater improvement on the angina-frequency subscale of the SAQ, however, was reported in the CABG group at 6 (P=.04) and 12 (P=.03) months, yet the differences between groups were small and did not reach 2 points for either periods. Although freedom from angina assessed by SAQ was similar for both procedures at 1 and 6 months, there was a trend toward an improvement in the CABG group at 1 year (P=.05).
In the conclusion of the study, the researchers said the symptomatic benefits of CABG were counterbalanced by the more rapid recovery and improved short-term health status achieved with PCI.
The study was funded by Boston Scientific. Previous coverage of the SYNTAX trial can be accessed here.
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