Newswise — Bypass surgery or angioplasty are often recommended for patients with heart failure. Anxious patients, however, understandably want to know if surgery is really necessary. Until recently, the evidence for the practice has been weak.
A study funded by the Canadian Institutes of Health Research and carried out by Dr. Ross Tsuyuki of the EPICORE Centre at the University of Alberta should reassure patients that surgery is, indeed, well worth it. He took a look at Alberta heart failure patients, including those who had either bypass surgery or angioplasty compared to those who did not. He found that mortality rates among those who had the procedures were half that of those who did not. (The alternative to surgery is management with medication and lifestyle changes.)
"These procedures should be considered in all patients with heart failure and coronary artery disease," says Dr. Tsuyuki.
Dr. Tsuyuki's work is part of an ongoing effort by Canadian researchers in all areas to determine whether what physicians recommend - which is often supported by rather weak evidence - actually works.
"People say, 'yeah, it makes sense that you should do that' and a lot of things make sense but we don't have any evidence," says Dr. Tsuyuki.
Sometimes, as in this case, the evidence supports the accepted practice. It's not easy getting this information though. For one thing, it's hard to set up a randomized controlled trial - the "gold standard" for testing effectiveness - if a practice, procedure or medication is already in wide use. That's where researchers like Dr. Tsuyuki come in, mining information from large databases of patients who have received the treatment or procedure.
"With large enough databases, you can screen out other variables and look at patient outcomes in terms of the practice or treatment you want to know more about," says Dr. Tsuyuki. "Our single-payer health-care system means that we actually have these databases to turn to - it's a huge Canadian advantage."
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