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Controversy continues regarding the preferred treatment for many subgroups of patients who require revascularization for coronary artery disease. New analyses suggest that the value of stenting may be less than that of coronary artery bypass grafting in several settings.
A meta-analysis compared stenting with minimally invasive CABG of the left anterior descending artery. Stenting was associated with a higher rate of recurrent angina (odds ratio, 2.62), a higher incidence of major cerebral and coronary events (OR, 2.86), and greater need for repeat coronary revascularization (OR, 4.63). Mortality was similar with the two approaches. A cost-effectiveness analysis using the same data showed stenting to be more cost-effective in the first 2 yea…