27 Mar 07
Coronary revascularisation
By D P Taggart
Surgery is effective on clinical and economic grounds, but stenting does not seem to be cost effective
This week, the BMJ publishes three studies dealing with revascularisation in ischaemic heart disease. Two of the studies compare the clinical effectiveness and cost effectiveness of revascularisation of isolated left anterior descending coronary disease by stenting or surgery, while the third examines the cost effectiveness of medical treatment, stenting, and surgery in multivessel disease. The studies raise key issues not only about the decision making process for intervention in the individual patient but also how to obtain maximum value from limited health service resources.