The SYNTAX trial (funded by the Disease Industry) report published today of 1800 triple vessel coronary artery disease CAD patients in USA and Europe claims that “CABG remains the standard of care for patients with three-vessel or left main coronary artery disease, since the use of CABG, as compared with PCI, resulted in lower rates of the combined end point of major adverse cardiac or cerebrovascular events at 1 year.”
BUT what the authors omit from the abstract is that
1. “At 12 months, the two groups had similar rates of death from any cause or myocardial infarction and of the combined end point of death from any cause, stroke, or myocardial infarction” (their quote from main text).
2. 106% of patients in the CABG group had CABG- open chest surgery (ie a few had repeat CABG or PCI) ; 111% of the PCI group had PCI, but only 2.8% of these patients had CABG- and the PCI patients had 75% fewer strokes- and far fewer of the PCI group needed warfarin, or amiodarone ie for severe arrhythmia.
Thus in the SYNTAX trial, for identical composite outcomes compared to CABG pts (93.35% survival at 12 months without death, stroke or MI), in the PCI group 97.2% of patients were spared thoracic surgery, and these patients had 73% fewer strokes than after CABG.
This new trial in patients with severe CAD (mean 65yrs, mostly males, overweight, 70% metabolic syndrome or diabetic) thus shows no overall benefit at 12 months from open thoracic surgery as opposed to PCI.
This outcome was similar to the 2008 Swiss study of acute coronary syndrome, which if anything by 3 years favoured initial PCI over CABG; and the 2004 Swiss TIME study in elderly patients with angina which showed similar outcome at 12 months with medical therapy without either initial angiogram, PCI or CABG as compared to the 100% having having these initial procedures.
The fact remains that overall, for proven CAD of whatever severity, there is no evidence of significant benefit at 3 (or ten) years from any invasive procedures (angiograms, PCI or CABG), compared to optimal medical prevention of all the major chronic degenerative diseases (CVD, osteoporosis, arthritis, diabetes, cancer, dementia).
This collection of aging diseases requires simple safe determined management of the major risk factors- overweight, frailty, stress depression, reactive oxygen species, atheroma and thrombogenesis – with diet, exercise, and appropriate supplements: fish oil, titrated metformin/galega; vigorous vitamins, magnesium- calcium, zinc, chromium, selenium, manganese; vitamins A to K; and the basket of proven essential human biologicals, micronutrients that deplete with aging and bad diet/lifestyle eg CoQ10, carnitine, arginine, ribose, Nacetyl cysteine, chondroglucosamine, lysine, 5HTP, GABA; melatonin and often thyroid, testosterone-estradiol and progesterone; and EDTA and a few selected herbs.
In particular, invasive procedures are contraindicated in those who will not stop smoking, since invasive procedures will prolong meaningful life only if they stop smoking!
To borrow Tom Hudson’s catchphrase in the CMAJ today , a “personalized transformative approach” is needed, for doctors to transform- stop promoting technology- drugs and invasive procedures- and instead guide the patient to transform effectively and safely with natural means.
World leaders in their respective clinical fields- eg the formerly -invasive cardiologists Drs Sinatra and Roberts; the psychiatrist Dr Eric Braverman, the gynaecologist Dr Ed Lichten , and the endocrinologist Dr Lee Vliet sum this approach up in their recent landmark books.
But most health professionals, like most patients, politicians, and Regulators, prefer the Disease Industry’s profitable quick-fix snakeoil solutions to grappling with truth – solutions which, unlike discipline and the natural supplements, do not address the primary causes of the common major degenerative diseases of aging as the natural approach does.
Only Disease pays the Disease Industry in Big Pharma ie the FDA’s War against Humanity.