The arm method is common in India, Israel, Europe and Canada, but less than 5 percent of US cases are done this way.
“This is the way we should be heading,’’ and more doctors should be trained to do it, said Dr. Edward McNulty of the University of California at San Francisco.
He is a leader of the American College of Cardiology conference in New Orleans where the studies were presented yesterday.
The bypass study’s surprising result is “a blockbuster,’’ McNulty said.
The operation did not improve survival for heart failure patients who already were taking medicines to control risks like high cholesterol and high blood pressure.
Clogged arteries cause about two-thirds of the 6 million cases of heart failure in the United States.
The heart isn’t getting enough blood and enlarges as it grows weaker from working too hard.
Doctors often advise bypass to improve blood flow, but the new study calls that into question.
“Even if surgery is better, it’s not better by much,’’ said Dr. Byron Lee, a heart specialist at the university.
The study involved 1,200 heart failure patients in 22 countries, mostly men around 60 years old. Most had a heart attack in the past. All were taking medicines they should for heart risks, and half were assigned to get bypass surgery also.
Doctors assumed bypass would cut deaths by 25 percent. But after nearly five years, about the same number in each group had died, said study leader Dr. Eric Velazquez of Duke University Medical Center.
One hundred people in the drug-alone group wound up having a bypass; 55 who were supposed to get the operation never did.
Results on only those who had the treatment they were initially assigned suggested that bypass surgery improved survival.
But its risks were evident, too.
For the first two years, there were more deaths among those given surgery versus the others.
“If you don’t have an expectation to outlive that two-year window,’’ surgery is not a good idea, Velazquez said.
The National Heart, Lung, and Blood Institute paid for the study, and Abbott Laboratories provided some medicines. Results were published online by the New England Journal of Medicine.
