Bypassing bypass surgery? Drug regimen may be just as effective for heart failure patients

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A new study presented this week at the American College of Cardiology conference in New Orleans and published online in the New England Journal of Medicine has some rather surprising results: bypass surgery does not improve survival for heart failure patients already on optimal drug therapy. Dr. Eric Velazquez and colleagues of Duke University Medical Center recruited 1,200 heart failure patients from 22 countries who were already taking medications to control for certain heart risks, including high cholesterol and high blood pressure. In addition to maintaining their drug regimen, half of the participants were assigned to receive bypass surgery, an operation performed to improve blood flow to clogged coronary arteries. After five years of follow-up, nearly the same number of people in each group died, but in the first two years, there were more deaths in the surgery group.

There are about six million cases of heart failure in the U.S., and “it is the most common cause of death and disability in the elderly,” cautions ACSH’s Dr. Gilbert Ross, “Most such patients should also be on aspirin, an ACE-inhibitor and a beta-blocker. This study underscores a very important point: people with certain cardiovascular risk factors should continue taking antihypertensive drugs and cholesterol-lowering drugs in order to increase their survival rates. And of course, they should not smoke.”