I refer to Ahmad Sobri's article Bypass grafting's edge over medical therapy . Allow me to first highlight that the writer is a surgeon and I am a physician.

My sincere request that the statistics regarding the morbidity and mortality rate (after surgical intervention) for coronary artery disease be revealed should not require any court order as Ahmad Sobri stated because there is nothing to hide from the public.

It should just be public health information. I don't believe that the matter falls in the domain of the Official Secrets Act or any other legislation.

Patients should be well-briefed about possible side effects and the consequences of surgical intervention prior to the invasive procedures.

Angioplasty (PTCA) or (PCI) is not superior to medical therapy. Bypass surgery, meanwhile, only eliminates anginal symptoms but does not prolong life or prevent heart attacks. After you put your life at risk on the operating table, the benefit is small. Therefore my presentation of Mass II trial was not out of context as stated. I quote :

"The big problem with angioplasty is that about 1 in 72 patients dies from the operation and twice that many from a bypass (concluded a recent summary from over 100 hospitals). The second problem is that neither operation prevents a future heart attack, none. This is because a bypass bypasses the problem, not solves the ongoing disease process, while ballooning/stenting only opens about 1/2 inch (1 cm) of an artery, and not the part that will cause a future heart attack.

"They are dangerous relievers of symptoms, such as angina, and for that they work well (for a while). Moreover, there are no studies that show a survival benefit from ballooning or bypassing apart from possibly the latter in a particular type of heart disease that is determined after you put your life at risk on the operating table, and the benefit is small. These procedures only treat the angiogram and not the vast majority of plaque which is buried in the wall but which can rupture and cause heart attacks."

Cardiologists say "Yes, we know that and we are relieving the symptoms" but why are so many done on people who are asymptomatic? And why all the 'screening' stress tests?

As a physician, I strongly believe we must think of in terms of Putting That Catheter Away (PTCA).