Grant: Project Grant

Blocked arteries reduce blood supply to the heart causing chest pain. Doctors use two procedures to restore the blood flow. Bypass surgery creates a new path around the blocked artery. Stenting reopens the blocked artery by inserting a tiny mesh tube, called stent. In clinical trials, bypass surgery had better results than stenting for treating multiple arteries. Therefore, doctors may suggest surgery rather than stenting for multiple blocked arteries. However, these trials did not include patients who had to wait for many weeks before receiving the treatment. We study results of bypass surgery and stenting done at various times after treatment decision. We want to find out whether waiting for bypass surgery is better than having immediate stenting. We use a patient registry to find results of bypass surgery and stenting in BC. First, we obtain registry data for patients with multiple blocked arteries. Second, we select those who did not need emergency treatment. Third, we link these data to hospital records and vital statistics. Then, we compare the frequency of treatment results in three groups of patients. The first group consist of patients who had bypass surgery by the time recommended by doctors. The other two groups are patients who had bypass surgery after the recommended time and those who had stenting. The proposed study will help strengthen health care in Canada. Our research will add new data from a large number of patients treated at various times after treatment decision. The data will help doctors to compare delayed surgery and immediate stenting. When recommending bypass surgery or stenting, doctors are concerned about unintended results of the treatment. The study will determine whether results of delayed bypass surgery are better than results of immediate stenting. This knowledge will help physicians decide how to treat blocked arteries when patients have to wait for surgery. The study will also advance methods for studying access to cardiac care.