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Dtsch Med Wochenschr 2005; 130(8): 402-407
DOI: 10.1055/s-2005-863065
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Kardiologie
© Georg Thieme Verlag Stuttgart · New York

Stentimplantation oder Bypass?

Aktuelle Datenlage bei Patienten mit stabiler koronarer HerzerkrankungStent implantation or bypass? Current data of patients with stable coronary diseaseS. Desch1 , G. Schuler1 , J. Niebauer1
  • 1Klinik für Innere Medizin/Kardiologie, Universität Leipzig - Herzzentrum GmbH
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Publication History

eingereicht: 21.6.2004

akzeptiert: 26.10.2004

Publication Date:
17 February 2005 (online)

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In den letzten Jahren gab es bei Patienten mit stabiler koronarer Herzerkrankung im Bereich perkutaner Revaskularisationsmaßnahmen und der aortokoronaren Bypassoperation zahlreiche neue Studienergebnisse und Therapieoptionen, die zum Teil weitreichenden Einfluss auf die klinische Praxis haben. Im Folgenden soll ein Überblick über die Entwicklung und den derzeitigen Stand verschiedener Revaskularisationsstrategien gegeben werden. Es wurde versucht, ausschließlich randomisierte kontrollierte Studien mit einer Fallzahl >  100 Patienten und auf deren Ergebnissen basierende Analysen in die Arbeit aufzunehmen. Hierzu wurden die Datenbank Medline sowie die Literaturverzeichnisse von nach Ansicht der Autoren wichtigen Publikationen durchsucht. Studien, die o. g. Kriterien nicht erfüllten, wurden nur berücksichtigt, wenn sie nach Meinung der Verfasser besondere Relevanz für einen Themenkomplex haben.

Literatur

  • 1 Abizaid A, Costa M A, Centemero M. et al . : Clinical and economic impact of diabetes mellitus on percutaneous and surgical treatment of multivessel coronary disease patients: insights from the Arterial Revascularization Therapy Study (ARTS) trial.  Circulation. 2001;  104 533-538
    Google Scholar
  • 2 Alderman E L, Bourassa M G, Cohen L S. et al . Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study.  Circulation. 1990;  82 1629-1646
    Google Scholar
  • 3 Al Suwaidi J. et al . Coronary artery stents.  JAMA. 2000;  284 1828-1836
    Google Scholar
  • 4 Angelini G D, Taylor F C, Reeves B C, Ascione R. Early and midterm outcome after off-pump and on-pump surgery in beating heart against cardioplegic arrest studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials.  Lancet. 2002;  359 1194-1199
    Google Scholar
  • 5 Barner H B, Standeven J W, Reese J. Twelve-year experience with internal mammary artery for coronary artery bypass.  J Thorac Cardiovasc Surg. 1985;  90 668-675
    Google Scholar
  • 6 Bucher H C, Hengstler P, Schindler C, Guyatt G H. Percutaneous transluminal coronary angioplasty versus medical treatment for non-acute coronary heart disease: meta-analysis of randomised controlled trials.  BMJ. 2000;  321 73-77
    Google Scholar
  • 7 Cameron A, Davis K B, Green G, Schaff H V. Coronary bypass surgery with internal thoracic artery grafts-effects on survival over a 15 year period.  N Engl J Med. 1996;  334 216-219
    Google Scholar
  • 8 Coronary angioplasty versus medical therapy for angina: the second randomised intervention treatment of angina (RITA-2) trial . RITA-2 trial participants.  Lancet. 1997;  350 461-468
    Google Scholar
  • 9 Coronary Artery Surgery Study (CASS): a randomized trial of coronary artery bypass surgery . Survival data.  Circulation. 1983;  68 939-950
    Google Scholar
  • 10 Davies R. et al . Asymptomatic cardiac ischemia pilot (ACIP) study two-year follow-up.  Circulation. 1997;  95 2037-2043
    Google Scholar
  • 11 Dawkins K. 9-Monats-Ergebnisse TAXUS VI. EuroPCR Paris 2004
    Google Scholar
  • 12 Diegeler A, Thiele H, Falk V. et al . Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery.  N Engl J Med. 2002;  347 561-566
    Google Scholar
  • 13 Eagle K A, Guyton R A, Davidoff R. et al . ACC/AHA Guidelines for CABG Surgery.  JACC. 1999;  34 1262-1347
    Google Scholar
  • 14 The Veterans Administration Coronary Artery Bypass Surgery Cooperative Study Group . Eleven-year survival in the Veterans Administration randomized trial of coronary bypass surgery for stable angina.  N Engl J Med. 1984;  311 1333-1339
    Google Scholar
  • 15 Erbel R, Haude M, Höpp H. et al . Coronary-artery stenting compared with balloon angioplasty for restenosis after initial balloon angioplasty.  N Engl J Med. 1998;  339 1672-1678
    Google Scholar
  • 16 Fischman D L, Leon M B, Baim D S. et al . A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease.  N Engl J Med. 1994;  331 496-501
    Google Scholar
  • 17 Hartigan P M. et al . Two- to three-year follow-up of patients with single-vessel coronary artery disease randomized to PTCA or medical therapy (results of a VA cooperative study).  Am J Cardiol. 1998;  82 1445-1450
    Google Scholar
  • 18 Henderson R A, Pocock S J, Sharp S J. et al . Long-term results of RITA-1 trial: clinical and cost comparison of coronary angioplasty and coronary-artery bypass grafting. Randomised Intervention Treatment of Angina.  Lancet. 1998;  352 1419-1425
    Google Scholar
  • 19 Hoffman S N, TenBrook J A, Wolf M P, Pauker S G, Salem D N, Wong J B. A meta-analysis of randomized controlled trials comparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty.  J Am Coll Cardiol. 2003;  41 1293-1304
    Google Scholar
  • 20 Khan N E. et al . A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery.  N Engl J Med. 2004;  350 21-28
    Google Scholar
  • 21 Lytle B W, Blackstone E H, Loop F D. et al . Two internal thoracic artery grafts are better than one.  J Thorac Cardiovasc Surg. 1999;  117 855-872
    Google Scholar
  • 22 Morice M C, Serruys P W, Sousa J E. et al . A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization.  N Engl J Med. 2002;  346 1773-1780
    Google Scholar
  • 23 Moses J W, Leon M B, Popma J J. et al . Sirolimus-Eluting Stents versus Standard Stents in Patients with Stenosis in a Native Coronary Artery.  N Engl J Med. 2003;  349 1315-1323
    Google Scholar
  • 24 Murphy M L, Hultgren H N, Detre K, Thomsen J, Takaro T. Treatment of chronic stable angina. A preliminary report of survival data of the randomized Veterans Administration cooperative Study.  N Engl J Med. 1977;  297 621-627
    Google Scholar
  • 25 Parisi A F, Folland E D, Hartigan P. A comparison of angioplasty with medical therapy in the treatment of single vessel coronary artery disease.  N Engl J Med. 1992;  326 10-16
    Google Scholar
  • 26 Pocock S J, Henderson R A, Rickards A F. et al . Meta-analysis of randomised trials comparing coronary angioplasty with bypass surgery.  Lancet. 1995;  346 1184-1189
    Google Scholar
  • 27 Second interim report by the European Coronary Surgery Study Group . Prospective randomised study of coronary artery bypass surgery in stable angina pectoris.  Lancet. 1980;  2 491-495
    Google Scholar
  • 28 Rodriguez A, Bernardi V, Navia J. et al . Argentine Randomized Study: Coronary Angioplasty with Stenting versus Coronary Bypass Surgery in patients with Multiple-Vessel Disease (ERACI II): 30-day and one-year follow-up results: ERACI II investigators.  J Am Coll Cardiol. 2001;  37 51-58
    Google Scholar
  • 29 Schampaert E, Cohen E A, Schluter M. et al . The Canadian study of the sirolimus-eluting stent in the treatment of patients with long de novo lesions in small native coronary arteries (C-SIRIUS).  J Am Coll Cardiol. 2004;  43 1110-1115
    Google Scholar
  • 30 Schofer J, Schluter M, Gershlick A H. et al . Sirolimus-eluting stents for treatment of patients with long atherosclerotic lesions in small coronary arteries: double-blind, randomized controlled trial (E-SIRIUS).  Lancet. 2003;  362 1093-1099
    Google Scholar
  • 31 Serruys P. 30-Tages-Ergebnisse ARTS-II. EuroPCR Paris 2004
    Google Scholar
  • 32 Serruys P W. 5-Jahres-Ergebnisse ARTS-I. ESC Munich 2004
    Google Scholar
  • 33 Serruys P W, Unger F, Sousa J E. et al . Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease.  N Engl J Med. 2001;  344 1117-1124
    Google Scholar
  • 34 Serruys P W, de Jaegere P, Kiemeneij F. et al . A Comparison of Balloon-Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease.  N Engl J Med. 1994;  331 489-495
    Google Scholar
  • 35 SoS investigators . Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomised controlled trial.  Lancet. 2002;  360 965-970
    Google Scholar
  • 36 Stone G W, Ellis S G, Cox D A. et al . A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease.  N Engl J Med. 2004;  350 221-231
    Google Scholar
  • 37 Taggart D P, D’Amico R, Altman D G. Effect of arterial revascularisation on survival: a systematic review of studies comparing bilateral and single internal mammary arteries.  Lancet. 2001;  358 870-875
    Google Scholar
  • 38 The Bypass Angioplasty Revascularization Investigation (BARI) Investigators . Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease.  N Engl J Med. 1996;  335 217-225
    Google Scholar
  • 39 van Dijk D, Nierich A P, Jansen E W. et al . Early outcome after off-pump versus on-pump coronary bypass surgery: results from a randomized study.  Circulation. 2001;  104 1761-1766
    Google Scholar
  • 40 Varnauskas E. Twelve-year follow-up of survival in the randomized European Coronary Surgery Study.  N Engl J Med. 1988;  319 332-337
    Google Scholar
  • 41 Yusuf S, Zucker D, Peduzzi P. et al . Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialist Collaboration.  Lancet. 1994;  344 563-570
    Google Scholar

Prof. Dr. Dr. J. Niebauer

Universität Leipzig - Herzzentrum GmbH

Strümpellstraße 39

04289 Leipzig

Phone: +49/341/8650

Fax: +49/341/8651461

Email: j.niebauer@medizin.uni-leipzig.de