CHICAGO — Heart failure patients with clogged arteries have a better chance of surviving 10 years if they get bypass surgery plus medicine rather than just drugs alone, according to an international study.

Earlier results from the same research raised questions about the benefits of bypass versus medicine alone, but researchers say the long-term evidence clearly favors the surgery.

The lead author of the study, Duke University cardiologist Dr. Eric Velazquez, said the results “are so definitive and so robust” that they would likely lead to stronger recommendations favoring bypass surgery for these patients.

Nearly 6 million Americans and 23 million people worldwide have heart failure, and many of them also have artery disease similar to those studied. In recent years, bypass surgery has increasingly been recommended for such patients, along with medicines to ease heart failure symptoms.

Concerns were raised in 2011 when results after nearly five years of research showed about equal number of deaths in bypass patients and in those who got only medicine, despite fewer heart-related deaths in the bypass group.

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