Spinal cord stimulation and coronary artery bypass grafting both significantly improved quality of life (P<0.001 vs run-in) with comparable 5-year mortality (27.9% overall).
RCT (n=104)
randomized
Does spinal cord stimulation improve quality of life and survival compared to coronary artery bypass grafting in patients with severe angina and increased surgical risk?
Spinal cord stimulation provides comparable long-term quality of life improvements and survival to coronary artery bypass grafting in high-risk patients with severe angina.
p-value: p=<0.001
AIMS: To assess the long-term outcome regarding quality of life and survival in patients who were included in the ESBY study 1992-1995. The ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris) included 104 patients-with severe angina, increased surgical risk and no prognostic benefits from revascularization-randomized to coronary artery bypass grafting or spinal cord stimulation. METHODS AND RESULTS: The ESBY patients' quality of life was analysed using two questionnaires, and 5-year mortality was assessed. Quality of life improved significantly 6 months after spinal cord stimulation and coronary artery bypass grafting, respectively, compared to run-in (P<0.001). The results were consistent after 4.8 years. The 5-year mortality was 27.9%. There were no significant differences between the groups. CONCLUSIONS: Spinal cord stimulation as well as coronary artery bypass grafting offered long-lasting improvement in quality of life. Survival up to 5 years was comparable between the groups. Both methods can be considered as effective treatment options for patients with severe angina, increased surgical risks and estimated to have no prognostic benefits from coronary artery bypass grafting.
“data from the Electrical Stimulation Bypass Surgery (ESBY) trial — which was published in Circulation in 1998 — suggested that SCS may be a therapeutic alternative for patients with an increased risk of surgical complications and no prognostic benefit from surgery”
Olof Ekre (Wed,) conducted a rct in Severe angina pectoris (n=104). Spinal cord stimulation vs. Coronary artery bypass grafting was evaluated on Quality of life and 5-year mortality (p=<0.001). Spinal cord stimulation and coronary artery bypass grafting both significantly improved quality of life (P<0.001 vs run-in) with comparable 5-year mortality (27.9% overall).